1164490108 NPI number — DR. FRANCISCO JAVIER QUINTANA GONZALEZ M.D.

Table of content: SONIA SHOUKAT M.D (NPI 1558746354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164490108 NPI number — DR. FRANCISCO JAVIER QUINTANA GONZALEZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QUINTANA GONZALEZ
Provider First Name:
FRANCISCO
Provider Middle Name:
JAVIER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164490108
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1243 BOULEVARD SAN LUIS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COTO LAUREL
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00780-2246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-290-1141
Provider Business Mailing Address Fax Number:
787-848-5985

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MARGINAL 506 LOCAL #2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COTO LAUREL PR
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-787-8487
Provider Business Practice Location Address Fax Number:
787-848-4539
Provider Enumeration Date:
03/08/2006

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: 207V00000X , with the licence number:  12768 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207VG0400X , with the licence number: 12768 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 768 . This is a "UIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 84083 . This is a "TRIPLE SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 02138 . This is a "AMERICAN HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 061926 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 601229 . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7650009 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7650009 . This is a "HUMANA PRIVADO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: M216 . This is a "MENONITA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7217 . This is a "IMC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40905 . This is a "PROSAM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: PE4588 . This is a "PALIC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 209485 . This is a "UTI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1540 . This is a "PMC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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