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General NPI Number Information
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NPI Number | 1538410097
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Entity Type | Organization
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Legal Business Name | MARK ANTHONY QUINTERO MD LLC
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3659 S MIAMI AVE STE 5003
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City | MIAMI
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State | FL
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Zip | 33133-4231
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Country | US
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Telephone | 305-860-5156
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Fax | 305-860-5314
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Provider Business Mailing Address
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Address Line | PO BOX 310074
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City | MIAMI
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State | FL
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Zip | 33231-0074
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Country | US
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Telephone | 305-860-5156
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Fax | 305-860-5314
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK A QUINTERO
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Credential | M. D.
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Telephone | 305-860-5156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME105392
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License Number State | FL
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