Provider Demographics
NPI:1629058052
Name:QUINONES, JEFFREY (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:QUINONES
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PARQ INTERAMERICANA
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784-7333
Mailing Address - Country:US
Mailing Address - Phone:787-864-7843
Mailing Address - Fax:
Practice Address - Street 1:LA FUENTE TOWN CTR
Practice Address - Street 2:SUITE 11123
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-6045
Practice Address - Country:US
Practice Address - Phone:787-866-1129
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10485208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics