Provider Demographics
NPI:1699307496
Name:MAHY QUINTERO, ELENA
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:MAHY QUINTERO
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 1:9870 N KENDALL DR APT F108
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1859
Mailing Address - Country:US
Mailing Address - Phone:305-993-8293
Mailing Address - Fax:
Practice Address - Street 1:9870 N KENDALL DR APT 108
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2195
Practice Address - Country:US
Practice Address - Phone:305-993-8293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator