Provider Demographics
NPI:1467934075
Name:DRA. KARINA QUINONES LEBRON, PSC
Entity Type:Organization
Organization Name:DRA. KARINA QUINONES LEBRON, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD, CAT
Authorized Official - Phone:787-852-3114
Mailing Address - Street 1:PO BOX 9138
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-9138
Mailing Address - Country:US
Mailing Address - Phone:787-852-3114
Mailing Address - Fax:787-285-5642
Practice Address - Street 1:111 CALLE FONT MARTELO E
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3935
Practice Address - Country:US
Practice Address - Phone:787-852-3114
Practice Address - Fax:787-285-5642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PR17835208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty