Healthcare Provider Details

I. General information

NPI: 1194671115
Provider Name (Legal Business Name): MARIA CRISTINA QUINTANA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19903 NW 67TH CIRCLE CT
HIALEAH FL
33015-2418
US

IV. Provider business mailing address

1 CVS DR
WOONSOCKET RI
02895-6195
US

V. Phone/Fax

Practice location:
  • Phone: 305-781-0760
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11048169
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: