Provider Demographics
NPI:1851338818
Name:QUINONES, LUIS E (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:E
Last Name:QUINONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12058 SAN JOSE BLVD
Mailing Address - Street 2:SUITE 903
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-1842
Mailing Address - Country:US
Mailing Address - Phone:904-886-0361
Mailing Address - Fax:904-886-0382
Practice Address - Street 1:12058 SAN JOSE BLVD
Practice Address - Street 2:SUITE 903
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-1842
Practice Address - Country:US
Practice Address - Phone:904-886-0361
Practice Address - Fax:904-886-0382
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 606082084P0804X, 2084P0800X, 2084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375614900Medicaid
FLF79125Medicare UPIN
FL375614900Medicaid