Healthcare Provider Details

I. General information

NPI: 1205969615
Provider Name (Legal Business Name): MR. JOSUE QUINTERO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 05/25/2022
Certification Date: 05/10/2022
Deactivation Date: 07/17/2007
Reactivation Date: 10/08/2014

III. Provider practice location address

CARRETERA 65 KL 3 SHOPING TUNEL CARCARE
SAN JUAN PR
00926
US

IV. Provider business mailing address

P.O. BOX 1880
BAYAMON PR
00953
US

V. Phone/Fax

Practice location:
  • Phone: 939-891-9911
  • Fax: 787-777-1577
Mailing address:
  • Phone: 787-730-8666
  • Fax: 787-777-1577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416S0300X
TaxonomyWater Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberTC-AMB-717
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: