Basic Information
Provider Information
NPI: 1467844217
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARCIA QUINTERO
FirstName: PEDRO
MiddleName: EMILIO
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 816759
Address2:  
City: HOLLYWOOD
State: FL
PostalCode: 330810759
CountryCode: US
TelephoneNumber: 3056741233
FaxNumber:  
Practice Location
Address1: 4300 ALTON RD DEPT OF
Address2:  
City: MIAMI BEACH
State: FL
PostalCode: 331402948
CountryCode: US
TelephoneNumber: 3056742200
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/02/2015
LastUpdateDate: 06/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XME144582FLY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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