Provider Demographics
NPI:1821526286
Name:QUINONES, GERMAN (PTA)
Entity Type:Individual
Prefix:
First Name:GERMAN
Middle Name:
Last Name:QUINONES
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:GERMAIN
Other - Middle Name:
Other - Last Name:QUINONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3009 VIA NAPOLI
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8625
Mailing Address - Country:US
Mailing Address - Phone:954-304-4504
Mailing Address - Fax:
Practice Address - Street 1:9215 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2404
Practice Address - Country:US
Practice Address - Phone:877-456-6352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA22362225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant