Provider Demographics
NPI:1932075637
Name:MATOS, BETHZAIDA (RN)
Entity type:Individual
Prefix:MRS
First Name:BETHZAIDA
Middle Name:
Last Name:MATOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:BETHZAIDA
Other - Middle Name:
Other - Last Name:QUINTANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PSC 480 BOX 1995
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09128-0020
Mailing Address - Country:US
Mailing Address - Phone:301-259-1307
Mailing Address - Fax:
Practice Address - Street 1:PSC 480 BOX 1995
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09128-0020
Practice Address - Country:US
Practice Address - Phone:301-259-1307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-11
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR225375163W00000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171400000XOther Service ProvidersHealth & Wellness Coach