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Individual

SUSANA QUINTERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 275-3222
(239) 278-9058
Mailing address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 275-3222
(239) 278-9058

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Q536780535520
DRIVER LICENSE
FL
Enumeration date
07/10/2012
Last updated
07/10/2012
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