Organization Active NPI

Quintina B. Corteza MD PA

  • Nephrology Physician
  • Leesburg, FL
National Provider Identifier
1558535591
Registry record updated Oct 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME0066395 Issued in FL
Legal business name
QUINTINA B. CORTEZA MD PA
Practice address
401 E. North Blvd
Suite 102a
Leesburg, FL 34748
Phone
(352) 314-3436
Fax
(352) 314-8638
NPI assigned
Apr 22, 2008
Last updated
Oct 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2010

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

Authorized official

Name
Dr. Quintina B Corteza, MDNPI 1255348876
Title
President
Phone
(352) 314-3436

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME0066395 FL Primary

Addresses

Primary practice location

401 E. North Blvd
Suite 102a
Leesburg, FL 34748

Mailing address

401 E. North Blvd
Suite 102a
Leesburg, FL 34748
Phone (352) 314-3436

Other identifiers 1

IdentifierTypeStateIssuer
377061300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101026000408 FL Part B Supplier - Clinic/Group Practice 3971796699 Receives reassigned benefits from 2 practitioners
Practice locations: Leesburg, FL; Lady Lake, FL

National Provider Directory

National Provider Directory

Locations

401 E North Blvd
Ste 102A
Leesburg, FL 34748
Phone (352) 314-3436

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288483200000",
    "number": "1558535591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E. NORTH BLVD",
            "address_2": "SUITE 102A",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "34748",
            "telephone_number": "352-314-3436",
            "fax_number": "352-314-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E. NORTH BLVD",
            "address_2": "SUITE 102A",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "34748",
            "telephone_number": "352-314-3436",
            "fax_number": "352-314-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINTINA B. CORTEZA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2010-10-31",
        "status": "A",
        "authorized_official_last_name": "CORTEZA",
        "authorized_official_first_name": "QUINTINA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-314-3436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME0066395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377061300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.