Individual
ALEXEY ACOSTA QUINTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 NEIGHBORHOOD PL, FAIRDALE, KY 40118-9697
(502) 774-8631
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 774-8631
(502) 772-8546
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4014131
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300093766
—
IN
05
—
31-000052
—
KY
05
—
7100964500
—
KY
Enumeration date
06/04/2022
Last updated
01/28/2026
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