Healthcare Provider Details
I. General information
NPI: 1891198636
Provider Name (Legal Business Name): YOANIA QUINTANA GARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/08/2014
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1350 HICKORY ST
MELBOURNE FL
32901-3224
US
IV. Provider business mailing address
3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US
V. Phone/Fax
- Phone: 321-434-1771
- Fax: 321-434-1775
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME138349 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | ME138349 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: