Provider Demographics
NPI:1467650515
Name:QUINONES, KIMBERLY HARDIN (OD)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:HARDIN
Last Name:QUINONES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14964 MAX LEGGETT PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-7270
Mailing Address - Country:US
Mailing Address - Phone:904-686-1386
Mailing Address - Fax:904-686-1363
Practice Address - Street 1:4871 TOWN CENTER PKWY STE 5
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-8310
Practice Address - Country:US
Practice Address - Phone:904-686-1386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4672152W00000X
PAOEG001964152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist