MEDICARE: DR. MARIA R QUINTERO MD

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	207R00000X	Internal Medicine Physician	8944	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	QU80437	OTHER		TRIPLE S
2	069426	OTHER		LA CRUZ AZUL DE PR

General Provider Information

NPI Number	:	1821064429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA R QUINTERO MD

Provider Business Mailing Address
First Line	:	PO BOX 475
Second Line	:
City	:	MOROVIS
State	:	PR
Zip	:	00687-0475
Country	:	US
Telephone Number	:	787-862-4350
Fax Number	:	787-862-4350

Provider Business Practice Location Address
First Line	:	36 CALLE PRINCIPAL ALTOS
Second Line	:
City	:	MOROVIS
State	:	PR
Zip	:	00687
Country	:	US
Telephone Number	:	787-862-4350
Fax Number	:	787-862-4350

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

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	07/08/2007

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