Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 7448 | FL |
NPI | 1275796898 |
---|---|
Provider Name | Maria De Los Angeles Quintero |
First Address | Doral, FL 33166-6682 |
Second Address | Doral, FL 33166-6682 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 03/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U00926 | (02) | FL |