Healthcare Provider Details

I. General information

NPI: 1134761786
Provider Name (Legal Business Name): CARDIOVASCULAR HEALTH CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 HOSPITAL ST STE 202
PASCAGOULA MS
39581-5310
US

IV. Provider business mailing address

4211 HOSPITAL ST STE 202
PASCAGOULA MS
39581-5310
US

V. Phone/Fax

Practice location:
  • Phone: 228-372-8270
  • Fax: 228-372-8271
Mailing address:
  • Phone: 228-372-8270
  • Fax: 228-372-8271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HUGO A QUINTANA
Title or Position: OWNER
Credential: MD
Phone: 228-372-8270