1194723262 NPI number — DR. OSCAR R QUINTERO SERRANO MD

Table of content: DR. OSCAR R QUINTERO SERRANO MD (NPI 1194723262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194723262 NPI number — DR. OSCAR R QUINTERO SERRANO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QUINTERO SERRANO
Provider First Name:
OSCAR
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
QUINTERO SERRANO
Provider Other First Name:
OSCAR
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1194723262
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
430 CALLE RUISENOR
Provider Second Line Business Mailing Address:
CAMINOS DEL SUR
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00716-2829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-844-6669
Provider Business Mailing Address Fax Number:
787-844-6888

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 CALLE FERROCARRIL
Provider Second Line Business Practice Location Address:
SUITE 302 SANTA MARIA MEDICAL BUILDING
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00717-1194
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-844-6669
Provider Business Practice Location Address Fax Number:
787-844-6888
Provider Enumeration Date:
07/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  10601 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1194723262 . This is a "NPI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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