Provider Demographics
NPI:1295931806
Name:QUINTANA, ROSANGELA (PHARMACIST TECHNICIA)
Entity type:Individual
Prefix:MISS
First Name:ROSANGELA
Middle Name:
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:PHARMACIST TECHNICIA
Other - Prefix:MISS
Other - First Name:ROSANGELA
Other - Middle Name:
Other - Last Name:QUINTANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACIST TECHNITIA
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:CASTANER
Mailing Address - State:PR
Mailing Address - Zip Code:00631-0355
Mailing Address - Country:US
Mailing Address - Phone:787-390-0615
Mailing Address - Fax:
Practice Address - Street 1:23 CALLE RAMON DE JESUS
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-2204
Practice Address - Country:US
Practice Address - Phone:787-897-2464
Practice Address - Fax:787-897-3231
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6579247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4705298OtherDRIVER LICENCE