MEDICARE: LESTER ARMANDO QUINTANA DURAN FNP

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	163W00000X	Registered Nurse	11014050	FL
2	363LF0000X	Family Nurse Practitioner	11014050	FL

General Provider Information

NPI Number	:	1760054126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESTER ARMANDO QUINTANA DURAN FNP

Provider Business Mailing Address
First Line	:	765 SW 101ST COURT CIR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-1880
Country	:	US
Telephone Number	:	786-439-4195
Fax Number	:

Provider Business Practice Location Address
First Line	:	2369 W 52ND ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-7210
Country	:	US
Telephone Number	:	305-825-0587
Fax Number	:

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

Provider Enumeration Date	:	07/15/2021
Last Update Date	:	05/06/2024

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