Basic Information
| Provider Information | |||||||||
| NPI: | 1306133988 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | QUINTERO-NAZARIO | ||||||||
| FirstName: | EDUARDO | ||||||||
| MiddleName: | JAVIER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2800 S SEACREST BLVD STE 110 | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334357960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612266610 | ||||||||
| FaxNumber: | 5612266611 | ||||||||
| Practice Location | |||||||||
| Address1: | 2800 S SEACREST BLVD STE 110 | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334357960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314445220 | ||||||||
| FaxNumber: | 6314445225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2011 | ||||||||
| LastUpdateDate: | 02/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 289888 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | 153144 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.