Provider Demographics
NPI:1225052087
Name:QUINLAN, JAMES LEE (DNP, ARNP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LEE
Last Name:QUINLAN
Suffix:
Gender:M
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 N. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-2136
Mailing Address - Country:US
Mailing Address - Phone:352-529-0477
Mailing Address - Fax:352-529-0406
Practice Address - Street 1:223 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-2136
Practice Address - Country:US
Practice Address - Phone:352-529-0477
Practice Address - Fax:352-529-0406
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2536632363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302886100Medicaid
FL10-8939Medicare PIN