Healthcare Provider Details

I. General information

NPI: 1336832450
Provider Name (Legal Business Name): HELENA QUACH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9911 CORKSCREW RD STE 101
ESTERO FL
33928-3323
US

IV. Provider business mailing address

632 DEL PRADO BLVD N STE 301
CAPE CORAL FL
33909-2278
US

V. Phone/Fax

Practice location:
  • Phone: 239-947-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME182336
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: