Provider Demographics
NPI:1528724531
Name:QUINTERO, MICHEL
Entity type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHEL
Other - Middle Name:
Other - Last Name:QUINTERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:518 PEACHTREE RD FL 32804
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6813
Mailing Address - Country:US
Mailing Address - Phone:407-730-7983
Mailing Address - Fax:
Practice Address - Street 1:518 PEACHTREE RD FL 32804
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-6813
Practice Address - Country:US
Practice Address - Phone:407-730-7983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-14
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health