Provider Demographics
NPI:1619674876
Name:ASENCIO QUINONES, GABRIELA MARELLIS (DC)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:MARELLIS
Last Name:ASENCIO QUINONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 AVE SAN PATRICIO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4505
Mailing Address - Country:US
Mailing Address - Phone:787-310-7801
Mailing Address - Fax:
Practice Address - Street 1:652 AVE SAN PATRICIO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4505
Practice Address - Country:US
Practice Address - Phone:939-231-4686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor