Healthcare Provider Details

I. General information

NPI: 1164337788
Provider Name (Legal Business Name): KAREN TATIANA QUINTANA RUIZ PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 7 BOX 32571
HATILLO PR
00659-9604
US

IV. Provider business mailing address

HC 7 BOX 32571
HATILLO PR
00659-9604
US

V. Phone/Fax

Practice location:
  • Phone: 787-503-1417
  • Fax:
Mailing address:
  • Phone: 787-503-1417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2250
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: