Provider Demographics
NPI:1932921673
Name:QUINTANA NUTRITIONAL SERVICES LLC
Entity type:Organization
Organization Name:QUINTANA NUTRITIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:QUINTANA FILIPPETTI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:787-432-6399
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty