Provider Demographics
NPI:1508477696
Name:RODRIGUEZ QUINONES, ANTONIO JOSE
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:JOSE
Last Name:RODRIGUEZ QUINONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 CALLE SANTA FE
Mailing Address - Street 2:
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656-1470
Mailing Address - Country:US
Mailing Address - Phone:939-629-7653
Mailing Address - Fax:
Practice Address - Street 1:183 CALLE SANTA FE
Practice Address - Street 2:
Practice Address - City:GUAYANILLA
Practice Address - State:PR
Practice Address - Zip Code:00656-1470
Practice Address - Country:US
Practice Address - Phone:939-629-7653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program