Provider Demographics
NPI:1023211570
Name:QUINONES, MARY PADILLA (RN,BSN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:PADILLA
Last Name:QUINONES
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BENITEZB-2 SIERRA BERDECIA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-604-5048
Mailing Address - Fax:
Practice Address - Street 1:B2 CALLE BENITEZ
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-6233
Practice Address - Country:US
Practice Address - Phone:787-604-5048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR018735163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice