Provider Demographics
NPI:1326296153
Name:QUINONES ROSADO, MARINES (MD)
Entity Type:Individual
Prefix:
First Name:MARINES
Middle Name:
Last Name:QUINONES ROSADO
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:PO BOX 1357
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-1357
Mailing Address - Country:US
Mailing Address - Phone:787-286-2800
Mailing Address - Fax:787-286-2805
Practice Address - Street 1:R25 CALLE 16
Practice Address - Street 2:SUNVILLE
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-4618
Practice Address - Country:US
Practice Address - Phone:787-308-7465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17263208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRGI019AMedicare PIN