Provider Demographics
NPI:1912197088
Name:QUINTANA VALENTIN, KATTY D (RPT)
Entity Type:Individual
Prefix:MS
First Name:KATTY
Middle Name:D
Last Name:QUINTANA VALENTIN
Suffix:
Gender:F
Credentials:RPT
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 2158
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-2158
Mailing Address - Country:US
Mailing Address - Phone:787-207-5860
Mailing Address - Fax:
Practice Address - Street 1:CARR 417 KM 1.0
Practice Address - Street 2:BO MALPASO
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-207-5860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist