| Doctor Name: | RODOLFO QUINTANA |
| NPI Number: | 1417918566 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 648027 |
| Business Practice Address: | 1585 3rd St Fort Polk, LA - 714595102 |
| Business Phone Number: | 3375317961 |
| Business Fax Number: | |
| Mailing Address: | 5403 Anderson Ct, FORT POLK |
| State: | LA |
| Postal Code: | 714593490 |
| Phone Number: | 3375317961 |
| Fax Number: | |
| NPI Enumeration Date: | 03/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 648027 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |