Provider Demographics
NPI:1902890684
Name:QUINTIN, ARDEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARDEN
Middle Name:
Last Name:QUINTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 CONCORD TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2815
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:954-858-0404
Practice Address - Street 1:3625 UNIVERSITY BLVD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4207
Practice Address - Country:US
Practice Address - Phone:904-399-6111
Practice Address - Fax:954-858-0404
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH53502080N0001X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010550400Medicaid
TX1264525Medicaid
TX1264525Medicaid