Provider Demographics
NPI:1831222017
Name:QUINTERO, ANA RUTH (OD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:RUTH
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 NIKKI VIEW DR
Mailing Address - Street 2:LAKE BRANDON PROFESSIONAL PARK
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4868
Mailing Address - Country:US
Mailing Address - Phone:813-651-1400
Mailing Address - Fax:
Practice Address - Street 1:1180 NIKKI VIEW DR
Practice Address - Street 2:LAKE BRANDON PROFESSIONAL PARK
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4868
Practice Address - Country:US
Practice Address - Phone:813-651-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3933152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist