Individual
MR. ANGEL LUIS QUINTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12821 SW 184TH TER, MIAMI, FL 33177-2507
(305) 775-2784
Mailing address
12821 SW 184TH TER, MIAMI, FL 33177-2507
(305) 775-2784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
171W00000X
Contractor
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CBHCM101908
FLORIDA CERTIFICATION BOARD
FL
Enumeration date
12/02/2007
Last updated
11/07/2018
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