Provider Demographics
NPI:1851918239
Name:QUINONES BRACERO, NATANYA
Entity Type:Individual
Prefix:MRS
First Name:NATANYA
Middle Name:
Last Name:QUINONES BRACERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 FOUNTAINHEAD CIR UNIT 156
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-3244
Mailing Address - Country:US
Mailing Address - Phone:787-427-9883
Mailing Address - Fax:
Practice Address - Street 1:401 FOUNTAINHEAD CIR UNIT 156
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-3244
Practice Address - Country:US
Practice Address - Phone:787-427-9883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty