Provider Demographics
NPI:1114066107
Name:QUINLEY, ANNA MARIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIA
Last Name:QUINLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:MARIA
Other - Last Name:MOTTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2395 CUMBERLAND WAY
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536
Mailing Address - Country:US
Mailing Address - Phone:850-689-2632
Mailing Address - Fax:
Practice Address - Street 1:1189 JOHN SIMS PKWY E
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-2752
Practice Address - Country:US
Practice Address - Phone:850-729-3684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 41305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist