Provider Demographics
NPI:1033958269
Name:PLASENCIA QUINTERO, LORENA DEL PILAR
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:DEL PILAR
Last Name:PLASENCIA QUINTERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17800 SW 154TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-7738
Mailing Address - Country:US
Mailing Address - Phone:954-669-2807
Mailing Address - Fax:
Practice Address - Street 1:17800 SW 154TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-7738
Practice Address - Country:US
Practice Address - Phone:954-669-2807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1048579106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician