Provider Demographics
NPI:1093343329
Name:QUIMBAYO, GIOVANNI ALFONSO (MD)
Entity Type:Individual
Prefix:DR
First Name:GIOVANNI
Middle Name:ALFONSO
Last Name:QUIMBAYO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11750 BIRD RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3530
Mailing Address - Country:US
Mailing Address - Phone:305-223-2000
Mailing Address - Fax:305-227-5556
Practice Address - Street 1:11750 BIRD RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3530
Practice Address - Country:US
Practice Address - Phone:305-223-2000
Practice Address - Fax:305-227-5556
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty