Provider Demographics
NPI:1427883545
Name:QUINTANA FILIPPETTI, EDWIN ANTONIO (RD)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:ANTONIO
Last Name:QUINTANA FILIPPETTI
Suffix:
Gender:M
Credentials:RD
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 8428
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-8428
Mailing Address - Country:US
Mailing Address - Phone:787-432-3195
Mailing Address - Fax:
Practice Address - Street 1:TORRE MEDICA SAN CRISTOBAL
Practice Address - Street 2:3007 AVE SAN CRISTOBAL STE 314
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2280
Practice Address - Country:US
Practice Address - Phone:787-432-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2260133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered