Provider Demographics
NPI:1538410097
Name:MARK ANTHONY QUINTERO MD LLC
Entity type:Organization
Organization Name:MARK ANTHONY QUINTERO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:QUINTERO
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:305-860-5156
Mailing Address - Street 1:PO BOX 310074
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33231-0074
Mailing Address - Country:US
Mailing Address - Phone:305-860-5156
Mailing Address - Fax:305-860-5314
Practice Address - Street 1:3659 S MIAMI AVE STE 5003
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4231
Practice Address - Country:US
Practice Address - Phone:305-860-5156
Practice Address - Fax:305-860-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105392207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty