Provider Demographics
NPI:1154198711
Name:QUINTANA, FABRIZIO AMAURI
Entity type:Individual
Prefix:
First Name:FABRIZIO
Middle Name:AMAURI
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9058 SW 148TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4119
Mailing Address - Country:US
Mailing Address - Phone:786-602-0011
Mailing Address - Fax:
Practice Address - Street 1:9020 SW 137TH AVE STE 214
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1427
Practice Address - Country:US
Practice Address - Phone:786-334-6991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician