1619967072 NPI number — MRS. GREIDA MARLENE QUINTERO PAZ MD

Table of content: MRS. GREIDA MARLENE QUINTERO PAZ MD (NPI 1619967072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619967072 NPI number — MRS. GREIDA MARLENE QUINTERO PAZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QUINTERO PAZ
Provider First Name:
GREIDA
Provider Middle Name:
MARLENE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1619967072
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
A28 CALLE MAIN
Provider Second Line Business Mailing Address:
URBANIZACION FLAMINGO HILLS
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00957-2339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-787-4706
Provider Business Mailing Address Fax Number:
787-787-4706

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE 6 ESQUINA 13 BLOQUE H-1 OFICINA #3 SANTA MONICA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-785-5454
Provider Business Practice Location Address Fax Number:
787-785-5454
Provider Enumeration Date:
10/26/2005

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: 208D00000X , with the licence number:  11733 , 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)





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