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Individual

DR. LUIS QUINTERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
951 N WASHINGTON AVE, TITUSVILLE, FL 32796-2163
(321) 268-6130
Mailing address
3 WALNUT TRACE CT, SIMPSONVILLE, SC 29681-4769
(864) 284-0494

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
8675
SC
207P00000X
Emergency Medicine Physician
Primary
ME37409
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05425
BLUE SHIELD
FL
Enumeration date
08/05/2006
Last updated
07/08/2007
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