MEDICARE: BRIAN PATRICK QUARANTA MD

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
1	2085R0001X	Radiation Oncology Physician	2002200774	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1168748	OTHER	NC	GATEWAY HEALTH
2	7435269	OTHER	NC	AETNA PROVIDER NUMBER
3	E3301	OTHER	NC	MEDCOST PROVIDER #
4	7267444003	OTHER	NC	CIGNA PROVIDER NUMBER
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	134WH	OTHER	NC	BCBS OF NC PROVIDER #

General Provider Information

NPI Number	:	1083600357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN PATRICK QUARANTA MD

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	445 BILTMORE AVE
Second Line	:	SUITE G-102
City	:	ASHEVILLE
State	:	NC
Zip	:	28801-4565
Country	:	US
Telephone Number	:	828-253-7077
Fax Number	:	828-253-6898

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	04/03/2023

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