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NPI Code Detail

MEDICARE: QUINTE PORTER

MEDICARE: QUINTE PORTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171W00000XContractor

General Provider Information

NPI Number : 1073458782
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUINTE PORTER
Provider Business Mailing Address
First Line : 6413 DINNING AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-1204
Country : US
Telephone Number : 725-262-5077
Fax Number :
Provider Business Practice Location Address
First Line : 6413 DINNING AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-1204
Country : US
Telephone Number : 725-262-5077
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2026
Last Update Date : 04/20/2026

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Directions to “ QUINTE PORTER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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