Healthcare Provider Details

I. General information

NPI: 1740158880
Provider Name (Legal Business Name): RODOLFO ANTONIO MONTIEL QUINTERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 HOUMA BLVD
METAIRIE LA
70006-2970
US

IV. Provider business mailing address

3410 SEVERN AVE APT 417
METAIRIE LA
70002-3409
US

V. Phone/Fax

Practice location:
  • Phone: 504-503-4000
  • Fax:
Mailing address:
  • Phone: 504-532-8754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number349670
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: