Provider Demographics
NPI:1710503495
Name:QUINONES, STEFANIE ALLISON (APRN)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:ALLISON
Last Name:QUINONES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3996
Mailing Address - Country:US
Mailing Address - Phone:305-951-3815
Mailing Address - Fax:
Practice Address - Street 1:199 MAIN RD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3996
Practice Address - Country:US
Practice Address - Phone:305-951-3815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008191363L00000X
FL9315047163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner