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Individual

ILIANNA POLATOS-QUINTERO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
17902 NW 81ST CT, HIALEAH, FL 33015-2847
(954) 815-9973
Mailing address
5645 CORAL RIDGE DR # 107, CORAL SPRINGS, FL 33076-3124
(954) 815-9973

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
3293252
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
677953196
FL
Enumeration date
07/07/2020
Last updated
07/07/2020
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