MEDICARE: ZORAIDA QUINTANA

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	1835P1200X	Pharmacotherapy Pharmacist	03119302	OH

General Provider Information

NPI Number	:	1508277658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZORAIDA QUINTANA

Provider Business Mailing Address
First Line	:	313 W HUBBARD AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-1345
Country	:	US
Telephone Number	:	614-599-2466
Fax Number	:

Provider Business Practice Location Address
First Line	:	5555 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4048
Country	:	US
Telephone Number	:	614-823-7833
Fax Number	:	614-823-7865

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

Provider Enumeration Date	:	05/12/2014
Last Update Date	:	05/12/2014

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Directions to “ ZORAIDA QUINTANA ” Practice Location

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