Provider Demographics
NPI:1699774802
Name:QUINTAL, ROBERTO E (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:E
Last Name:QUINTAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3600 PRYTANIA ST STE 35
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3678
Mailing Address - Country:US
Mailing Address - Phone:504-897-8412
Mailing Address - Fax:504-891-9862
Practice Address - Street 1:3715 PRYTANIA ST STE 400
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3768
Practice Address - Country:US
Practice Address - Phone:504-897-8276
Practice Address - Fax:504-897-8336
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA05566R207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1322849Medicaid
LA5K647D516Medicare PIN
LA1322849Medicaid
LAB89087Medicare UPIN