Provider Demographics
NPI:1871633537
Name:TANGUILIG, EDITA QUITAIN (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:EDITA
Middle Name:QUITAIN
Last Name:TANGUILIG
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:EDITA
Other - Middle Name:MARQUEZ
Other - Last Name:QUITAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2965 MUNICIPAL WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2965 MUNICIPAL WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304
Practice Address - Country:US
Practice Address - Phone:850-487-3162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2946482163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health