MEDICARE: MRS. MARIVIC QUINTINITA DNP

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	363LF0000X	Family Nurse Practitioner	ARNP3088522	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1730381641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIVIC QUINTINITA DNP

Provider Business Mailing Address
First Line	:	3808 S HOPKINS AVE
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32780-5753
Country	:	US
Telephone Number	:	321-433-3000
Fax Number	:	321-433-3001

Provider Business Practice Location Address
First Line	:	3808 S HOPKINS AVE
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32780-5753
Country	:	US
Telephone Number	:	321-433-3000
Fax Number	:	321-433-3001

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

Provider Enumeration Date	:	06/03/2007
Last Update Date	:	04/16/2026

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