MEDICARE: MRS. DIANA MARIE QUINTERO LCSW

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	1041C0700X	Clinical Social Worker	SW18436	FL

General Provider Information

NPI Number	:	1528913894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIANA MARIE QUINTERO LCSW

Provider Business Mailing Address
First Line	:	1420 W VIRGINIA LN
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-2327
Country	:	US
Telephone Number	:	727-422-1808
Fax Number	:

Provider Business Practice Location Address
First Line	:	1961 ASHLAND DR
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33763-2209
Country	:	US
Telephone Number	:	727-422-1808
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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