Provider Demographics
NPI:1942018106
Name:QUINTANA, PABLO E (PSYD)
Entity type:Individual
Prefix:DR
First Name:PABLO
Middle Name:E
Last Name:QUINTANA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 30427
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9198
Mailing Address - Country:US
Mailing Address - Phone:787-404-6429
Mailing Address - Fax:
Practice Address - Street 1:CARR EST PR-2 KM 122.8 BO CAIMITAL ALTO
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-9198
Practice Address - Country:US
Practice Address - Phone:787-404-6429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR008246103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist