Provider Demographics
NPI:1134324320
Name:QUINONES, EILEEN MARTIZA (MD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:MARTIZA
Last Name:QUINONES
Suffix:
Gender:F
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:URB PORTA COELI ST 2 B 9
Mailing Address - Street 2:ST 2 B 9
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-892-2408
Mailing Address - Fax:
Practice Address - Street 1:20 URB LAS DELICIAS
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660-1530
Practice Address - Country:US
Practice Address - Phone:787-892-2408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10902202C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG04594Medicare UPIN