Provider Demographics
NPI:1821367939
Name:QUINONES, ALEX VICTOR
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:VICTOR
Last Name:QUINONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13340 SW 90TH TER APT F
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1718
Mailing Address - Country:US
Mailing Address - Phone:786-210-5256
Mailing Address - Fax:
Practice Address - Street 1:13340 SW 90TH TER APT F
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1718
Practice Address - Country:US
Practice Address - Phone:786-210-5256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9250373367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered