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NPI Code Detail

MEDICARE: JORGE E. QUINTERO

MEDICARE: JORGE E. 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
1122300000XDentistDN18459FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306299987
Entity Type Code : Organization
Provider Name (Legal Business Name) : JORGE E. QUINTERO
Provider Business Mailing Address
First Line : 7326 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-6055
Country : US
Telephone Number : 407-658-4060
Fax Number : 407-658-4062
Provider Business Practice Location Address
First Line : 7326 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-6055
Country : US
Telephone Number : 407-658-4060
Fax Number : 407-658-4062
Authorized Official
Title or Position : OFFICE MANAGER
Name : MR. HECTOR LEON
Credential :
Telephone Number : 407-658-4060
Provider Enumeration Date : 07/19/2016
Last Update Date : 07/19/2016

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Directions to “JORGE E. QUINTERO ” Practice Location

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