Provider Demographics
NPI:1134700586
Name:SANTANA QUINONEZ, CLAUDIA MARIE (SA-C)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:MARIE
Last Name:SANTANA QUINONEZ
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11390 SQUARE ST UNIT 1119
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4048
Mailing Address - Country:US
Mailing Address - Phone:904-228-9812
Mailing Address - Fax:
Practice Address - Street 1:11390 SQUARE ST UNIT 1119
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-4048
Practice Address - Country:US
Practice Address - Phone:904-228-9812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21-167246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant