Provider Demographics
NPI:1003848565
Name:HURD QUINONES, MARY K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:K
Last Name:HURD QUINONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:K
Other - Last Name:HURD QUINONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4881 NW 8TH AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-373-6338
Mailing Address - Fax:352-373-6144
Practice Address - Street 1:21 HOSPITAL DR STE 125
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2455
Practice Address - Country:US
Practice Address - Phone:386-206-5177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77643207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256485800Medicaid
G88546Medicare UPIN
FL256485800Medicaid
FLE2218Medicare ID - Type Unspecified