MEDICARE: MARIA DINA QUINTELA OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT5391	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	391402	OTHER	FL	AVMED
2	Z04WG	OTHER	FL	FLORIDA BLUE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033255781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DINA QUINTELA OT

Provider Business Mailing Address
First Line	:	7852 LACHLAN DR
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-5145
Country	:	US
Telephone Number	:	727-376-7928
Fax Number	:

Provider Business Practice Location Address
First Line	:	36413 US HIGHWAY 19 N
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-1329
Country	:	US
Telephone Number	:	813-978-9700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	12/04/2023

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Directions to “ MARIA DINA QUINTELA OT” Practice Location

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