Individual provider Active NPI

Yaquelin L Quintero, NP-C

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1629379458
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F0910402 Issued in FL
Practice address
14521 University Point PL
Tampa, FL 33613-5424
Phone
(813) 977-3600
Fax
(813) 977-1664
NPI assigned
Nov 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F0910402 FL Primary

Addresses

Primary practice location

14521 University Point PL
Tampa, FL 33613-5424

Mailing address

6722 Gateway Dr
Tampa, FL 33615-2962
Phone (813) 654-2544

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110216000889 FL Practitioner - Nurse Practitioner 9931380458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leavitt Medical Associates of Florida IncGroup PAC ID 4688579311, 199 clinicians

Practice addresses (Care Compare)

1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100

14521 University Point PL
Tampa, FL 33613-5424
Phone (813) 977-3600

1503 Buenos Aires Blvd
Suite 100
The Villages, FL 32159-6825
Phone (352) 753-2812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F0910402FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Oct 6, 2012 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Oct 6, 2012 Accepting new patients
Center for Dermatology and Skin Surgery Inc Past Accepting new patients
Kaf Path LLC Past Accepting new patients

Locations

26344 US Highway 19 N
Clearwater, FL 33761
Phone (727) 669-3676

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

8209 State Road 54
New Prt Rchy, FL 34655
Phone (727) 569-1055

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

14521 University Point Pl
Tampa, FL 33613
Phone (813) 977-3600

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

27612 Cashford Cir
Ste 102
Wesley Chapel, FL 33544
Phone (813) 991-1457

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1629379458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6722 GATEWAY DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336152962",
            "telephone_number": "813-654-2544",
            "fax_number": "813-653-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14521 UNIVERSITY POINT PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336135424",
            "telephone_number": "813-977-3600",
            "fax_number": "813-977-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "YAQUELIN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "F0910402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.