Provider Demographics
NPI:1104380591
Name:QUINTANA RAMIREZ, ELIOENAI
Entity Type:Individual
Prefix:
First Name:ELIOENAI
Middle Name:
Last Name:QUINTANA RAMIREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 CALLE COLOMER
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2721
Mailing Address - Country:US
Mailing Address - Phone:787-598-0399
Mailing Address - Fax:
Practice Address - Street 1:118 CALLE COLOMER
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-2721
Practice Address - Country:US
Practice Address - Phone:787-598-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program