Provider Demographics
NPI:1972934594
Name:DR.FRANCISCO J. QUINTANA GONZALEZ LLC
Entity type:Organization
Organization Name:DR.FRANCISCO J. QUINTANA GONZALEZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:J
Authorized Official - Last Name:QUINTANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-848-7766
Mailing Address - Street 1:1243 BULEVAR SAN LUIS
Mailing Address - Street 2:COTO LAUREL
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2246
Mailing Address - Country:US
Mailing Address - Phone:787-848-7766
Mailing Address - Fax:787-848-4539
Practice Address - Street 1:1243 BULEVAR SAN LUIS
Practice Address - Street 2:COTO LAUREL
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2246
Practice Address - Country:US
Practice Address - Phone:787-848-7766
Practice Address - Fax:787-848-4539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-07
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12768302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization