Individual provider Active NPI

Myrta Y Quintana Latorre, MD

  • Family Medicine Physician
  • San Sebastian, PR
National Provider Identifier
1124122379
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13242 Issued in PR
Practice address
1800 Ave Emerito Estrada
San Sebastian, PR 00685-3030
Phone
(787) 896-5788
Fax
(787) 896-5788
NPI assigned
Sep 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13242 PR Primary

Addresses

Primary practice location

1800 Ave Emerito Estrada
San Sebastian, PR 00685-3030

Mailing address

PO Box 5028
San Sebastian, PR 00685
Phone (787) 896-5788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210000867 PR Practitioner - Family Practice 2668378597 Practice locations: San Sebastian, PR

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1800 Ave Emerito Estrada
San Sebastian, PR 00685-3030
Phone (787) 896-5788

PO Box
Suite 5028
San Sebastian, PR 00685-5028

Hospital & facility affiliations

  • Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas Inc Hospice, Ponce, PR, CCN 401530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13242PRMDFamily Medicine Physician

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1124122379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5028",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "00685",
            "telephone_number": "787-896-5788",
            "fax_number": "787-896-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 AVE EMERITO ESTRADA",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006853030",
            "telephone_number": "787-896-5788",
            "fax_number": "787-896-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA LATORRE",
        "first_name": "MYRTA",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-09",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "13242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Sebastian, PR

Sources for this page

Verify at the official NPI Registry.