Provider Demographics
NPI:1659502771
Name:QUINONES BARBOSA, GRETCHEN (MD)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:QUINONES BARBOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-0144
Mailing Address - Country:US
Mailing Address - Phone:787-231-7458
Mailing Address - Fax:
Practice Address - Street 1:COND. GRANADA 1757 MCLEARY
Practice Address - Street 2:APT. 4H
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1276
Practice Address - Country:US
Practice Address - Phone:787-231-7458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR190192085R0202X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice