Provider Demographics
NPI:1437535622
Name:QUINTERO, RITA (LND)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195-49 CALLE 530
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-3108
Mailing Address - Country:US
Mailing Address - Phone:787-638-7222
Mailing Address - Fax:
Practice Address - Street 1:AVE MONSERRATE
Practice Address - Street 2:BA-22 CALLE TULIPAN VALLE ARRIBA HEIGHTS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5444
Practice Address - Country:US
Practice Address - Phone:787-638-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1366133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist