Provider Demographics
NPI:1396174744
Name:QUINTANA, YOSSY
Entity type:Individual
Prefix:
First Name:YOSSY
Middle Name:
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 1:870 NW 87TH AVE
Mailing Address - Street 2:APT 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3454
Mailing Address - Country:US
Mailing Address - Phone:786-516-1389
Mailing Address - Fax:
Practice Address - Street 1:705 LE JEUNE RD
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4613
Practice Address - Country:US
Practice Address - Phone:305-883-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator