Healthcare Provider Details

I. General information

NPI: 1194723262
Provider Name (Legal Business Name): OSCAR R QUINTERO SERRANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: OSCAR R QUINTERO SERRANO MD

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 CALLE FERROCARRIL SUITE 302 SANTA MARIA MEDICAL BUILDING
PONCE PR
00717-1194
US

IV. Provider business mailing address

430 CALLE RUISENOR CAMINOS DEL SUR
PONCE PR
00716-2829
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-6669
  • Fax: 787-844-6888
Mailing address:
  • Phone: 787-844-6669
  • Fax: 787-844-6888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number10601
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: