Provider Demographics
NPI:1104856590
Name:QUINN, DIANA MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:MARIE
Last Name:QUINN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:DIANA
Other - Middle Name:MARIE
Other - Last Name:DOWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5840 CORPORATE WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2040
Mailing Address - Country:US
Mailing Address - Phone:561-432-0111
Mailing Address - Fax:561-432-1075
Practice Address - Street 1:6169 S JOG RD STE A11
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6586
Practice Address - Country:US
Practice Address - Phone:561-432-0111
Practice Address - Fax:561-432-1075
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT-004948225100000X
FL33265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist