Provider Demographics
NPI:1205950920
Name:QUINTANA, CARLOS ALFONSO (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ALFONSO
Last Name:QUINTANA
Suffix:
Gender:M
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:PO BOX 1710
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-1710
Mailing Address - Country:US
Mailing Address - Phone:787-438-6263
Mailing Address - Fax:787-834-3408
Practice Address - Street 1:HOSPITAL PEREA
Practice Address - Street 2:DR BASORA ST
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13313146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant