Healthcare Provider Details

I. General information

NPI: 1578298378
Provider Name (Legal Business Name): JOSE A QUINTERO ESTADES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

J9 AVE SAN PATRICIO URB. LOS CAOBOS
GUAYNABO PR
00968-4404
US

IV. Provider business mailing address

311 CALLE TERESA JORNET APT 703
SAN JUAN PR
00926-7395
US

V. Phone/Fax

Practice location:
  • Phone: 787-773-1128
  • Fax:
Mailing address:
  • Phone: 787-307-0050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: JOSE QUINTERO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-307-0050