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NPI Code Detail

MEDICARE: YURI RICARDO QUINTERO

MEDICARE: YURI RICARDO QUINTERO
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1275308504
Entity Type Code : Individual
Provider Name (Legal Business Name) : YURI RICARDO QUINTERO
Provider Business Mailing Address
First Line : 2615 W 64TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33016-4385
Country : US
Telephone Number : 786-498-1257
Fax Number :
Provider Business Practice Location Address
First Line : 2615 W 64TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33016-4385
Country : US
Telephone Number : 786-498-1257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2023
Last Update Date : 11/16/2023

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Directions to “ YURI RICARDO QUINTERO ” Practice Location

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