Provider Demographics
NPI:1144474479
Name:QUINTANA, MARIA ELENA (LMT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 NW 41ST ST # 5
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7470
Mailing Address - Country:US
Mailing Address - Phone:352-372-3181
Mailing Address - Fax:352-372-3181
Practice Address - Street 1:2631 NW 41ST ST # 5
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7470
Practice Address - Country:US
Practice Address - Phone:352-372-3181
Practice Address - Fax:352-372-3181
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 25828174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist