=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811255599
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LARI J QUINTERO ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2012
-----------------------------------------------------
Last Update Date | 02/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 587 E SR 434 UNIT 3013
-----------------------------------------------------
City | LONGWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32750-5240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-554-9790
-----------------------------------------------------
Fax | 407-550-1129
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1540 INTERNATIONAL PKWY STE 2000
-----------------------------------------------------
City | LAKE MARY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32746-5096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-252-7011
-----------------------------------------------------
Fax | 407-550-1129
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN9162312
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------