Healthcare Provider Details

I. General information

NPI: 1134214802
Provider Name (Legal Business Name): CHRISTIAN QUINTERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N PARK RD STE 202
HOLLYWOOD FL
33021-6987
US

IV. Provider business mailing address

450 N PARK RD STE 202
HOLLYWOOD FL
33021-6987
US

V. Phone/Fax

Practice location:
  • Phone: 672-210-8539
  • Fax: 561-996-9620
Mailing address:
  • Phone: 267-210-8539
  • Fax: 954-505-3431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME11507
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME11507
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: