Provider Demographics
NPI:1548248164
Name:QUINTOS, JOSE BERNARDO Q (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE BERNARDO
Middle Name:Q
Last Name:QUINTOS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:HCH 122
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1177
Mailing Address - Country:US
Mailing Address - Phone:401-444-6195
Mailing Address - Fax:401-444-6378
Practice Address - Street 1:1 HOPPIN ST
Practice Address - Street 2:CORO WEST SUITE 200
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4141
Practice Address - Country:US
Practice Address - Phone:401-444-5504
Practice Address - Fax:401-444-2534
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2008-04-16
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Provider Licenses
StateLicense IDTaxonomies
RIMD122622080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI12262OtherSTATE LICENSE
RI1548248Medicaid
RI1548248Medicaid