Provider Demographics
NPI:1568051365
Name:QUINTANA BAEZ, CRISTINA MARI
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARI
Last Name:QUINTANA BAEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3703
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-3703
Mailing Address - Country:US
Mailing Address - Phone:787-374-2171
Mailing Address - Fax:
Practice Address - Street 1:BO. GUATEMALA
Practice Address - Street 2:CARR. 111 KM 16.8 INT
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-374-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3081235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty