Individual
MARCUS QUINTANILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
113 LIELMANIS AVE, HURLBURT FIELD, FL 32544-5613
(850) 881-5378
Mailing address
428 SANDY RIDGE CIR, MARY ESTHER, FL 32569-2112
(361) 249-4488
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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