Provider Demographics
NPI:1083174387
Name:QUINONEZ, JOSE MARIO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:MARIO
Last Name:QUINONEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:51 N 39TH STREET
Mailing Address - Street 2:PPMC, DEPARTMENT OF MEDICINE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-8989
Mailing Address - Fax:215-662-8989
Practice Address - Street 1:51 N 39TH STREET
Practice Address - Street 2:PPMC, DEPARTMENT OF MEDICINE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-8989
Practice Address - Fax:215-662-8989
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD477757207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine