Provider Demographics
NPI:1023411147
Name:PUPO QUINTANA, ARIAN (MD)
Entity type:Individual
Prefix:
First Name:ARIAN
Middle Name:
Last Name:PUPO QUINTANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 NW 15TH ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2990
Mailing Address - Country:US
Mailing Address - Phone:786-894-6358
Mailing Address - Fax:
Practice Address - Street 1:9980 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6139
Practice Address - Country:US
Practice Address - Phone:954-334-3151
Practice Address - Fax:305-675-5719
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME157927207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine