Healthcare Provider Details

I. General information

NPI: 1669247987
Provider Name (Legal Business Name): Q PEDIATRICS PR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

41 CALLE CRISTOBAL COLON
YABUCOA PR
00767-3324
US

IV. Provider business mailing address

41 CALLE CRISTOBAL COLON
YABUCOA PR
00767-3324
US

V. Phone/Fax

Practice location:
  • Phone: 939-458-0939
  • Fax:
Mailing address:
  • Phone: 939-458-0939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SANTIAGO E QUILES GUZMAN
Title or Position: PRIOPIETARY
Credential: MD
Phone: 787-366-7445