Provider Demographics
NPI:1487337689
Name:MAYO QUINTERO, MAJELA (APRN)
Entity type:Individual
Prefix:MS
First Name:MAJELA
Middle Name:
Last Name:MAYO QUINTERO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 NW 47TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2135
Mailing Address - Country:US
Mailing Address - Phone:786-234-1751
Mailing Address - Fax:
Practice Address - Street 1:470 NW 47TH AVE APT 3
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2135
Practice Address - Country:US
Practice Address - Phone:786-234-1751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028044363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily