Provider Demographics
NPI:1902952724
Name:QUINTERO, INEABELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:INEABELLE
Middle Name:
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3112 AVE JUAN HERNANDEZ ORTIZ
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3614
Mailing Address - Country:US
Mailing Address - Phone:787-872-5165
Mailing Address - Fax:787-872-5165
Practice Address - Street 1:3112 AVE JUAN HERNANDEZ ORTIZ
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-3614
Practice Address - Country:US
Practice Address - Phone:787-872-5165
Practice Address - Fax:787-872-5165
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR268152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR051564OtherCRUZ AZUL
PR215213OtherPREFERRED HEALTH PLAN
PR53860OtherINTERNATIONAL MEDICAL CAR
PR0660476694OtherMCS OPTICA
PR50681OtherPMC
PR58156OtherSSS
PR068-268OtherGLOBAL HEALTH PLAN
PR2071-5OtherASOC DE MAESTROS
PR5274OtherAMERICAN HEALTH MEDICARE
PR2071-5OtherASOC DE MAESTROS
PR50681OtherPMC