Provider Demographics
NPI:1710310065
Name:QUINONES - IRIZARRY, VIRMARYS (PHL)
Entity Type:Individual
Prefix:MS
First Name:VIRMARYS
Middle Name:
Last Name:QUINONES - IRIZARRY
Suffix:
Gender:F
Credentials:PHL
Other - Prefix:MS
Other - First Name:VIRMARYS
Other - Middle Name:
Other - Last Name:QUINONES - IRIZARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS SLP
Mailing Address - Street 1:CARR. 455 INT. R-4453
Mailing Address - Street 2:K.M. 10.1
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669
Mailing Address - Country:US
Mailing Address - Phone:787-203-2186
Mailing Address - Fax:
Practice Address - Street 1:CARR. 4454 INT
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-203-2186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14582355S0801X
PR3062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant