Provider Demographics
NPI:1255674602
Name:QUINONES, VIRGEN M (PHTEC)
Entity Type:Individual
Prefix:
First Name:VIRGEN
Middle Name:M
Last Name:QUINONES
Suffix:
Gender:F
Credentials:PHTEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 6211
Mailing Address - Street 2:
Mailing Address - City:LOIZA
Mailing Address - State:PR
Mailing Address - Zip Code:00772-9731
Mailing Address - Country:US
Mailing Address - Phone:787-209-5253
Mailing Address - Fax:
Practice Address - Street 1:CARR 188 ESQUINA CALLE C #41
Practice Address - Street 2:
Practice Address - City:LOIZA
Practice Address - State:PR
Practice Address - Zip Code:00772
Practice Address - Country:US
Practice Address - Phone:787-876-3106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7921183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician