Active NPI
Mario Ignacio Quintana Martinez, APRN
- Family Nurse Practitioner
- Hialeah, FL
National Provider Identifier
1104441161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11006342
- Practice address
- 315 W 9TH St
Hialeah, FL 33010-3853 - Phone
- (786) 360-4528
- Fax
- (786) 360-4529
- NPI assigned
- Jun 15, 2020
- Last updated
- Nov 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11006342 | FL | Primary |
Addresses
Primary practice location
315 W 9TH St
Hialeah, FL 33010-3853
Mailing address
2510 W 56TH St Apt 2320
Hialeah, FL 33016-4765
Phone (786) 210-3860
Other practice location 1
10920 W Flagler St Ste 201
Miami, FL 33174-1243
Phone (786) 623-3915
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q535549622711 | Other | FL | DRIVERS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Vida Medical Centers
- Multi-Specialty Clinic/Center
- Hialeah, FL
- NPI 1417233222
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1104441161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2510 W 56TH ST APT 2320",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330164765",
"telephone_number": "786-210-3860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 W 9TH ST",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330103853",
"telephone_number": "786-360-4528",
"fax_number": "786-360-4529"
}
],
"practiceLocations": [
{
"address_1": "10920 W Flagler St Ste 201",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331741243",
"country_code": "US",
"telephone_number": "786-623-3915",
"fax_number": "786-623-3916",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "QUINTANA MARTINEZ",
"first_name": "MARIO",
"middle_name": "IGNACIO",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-15",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11006342",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "Q535549622711",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.