Provider Demographics
NPI:1801932678
Name:QUINTERO, SAUL EDUARDO (MD)
Entity type:Individual
Prefix:
First Name:SAUL
Middle Name:EDUARDO
Last Name:QUINTERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 MALLARD RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1124
Mailing Address - Country:US
Mailing Address - Phone:954-260-1125
Mailing Address - Fax:509-272-9943
Practice Address - Street 1:2901 CORAL HILLS DR STE 370
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4146
Practice Address - Country:US
Practice Address - Phone:954-603-9630
Practice Address - Fax:877-812-2231
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87430207Q00000X
FLME 87430207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL48712DOtherFLORIDA BLUE
FL2641925 00Medicaid
FLE7364 AMedicare ID - Type Unspecified
FL000114707OtherHUMANA