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NPI Code Detail

MEDICARE: MARY E QUILLINAN D.O.

MEDICARE: MARY E QUILLINAN D.O.
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
1207R00000XInternal Medicine PhysicianOS0006716FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235134750
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY E QUILLINAN D.O.
Provider Business Mailing Address
First Line : 1000 36TH ST
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4862
Country : US
Telephone Number : 772-567-4311
Fax Number :
Provider Business Practice Location Address
First Line : 1000 36TH ST
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4862
Country : US
Telephone Number : 863-607-4336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 08/22/2023

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Directions to “ MARY E QUILLINAN D.O.” Practice Location

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