Provider Demographics
NPI:1881630796
Name:QUINN, NATASSA LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:NATASSA
Middle Name:LEE
Last Name:QUINN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 242
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-0242
Mailing Address - Country:US
Mailing Address - Phone:813-654-2445
Mailing Address - Fax:813-654-9885
Practice Address - Street 1:500 VONDERBURG DR
Practice Address - Street 2:311 WEST
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5964
Practice Address - Country:US
Practice Address - Phone:813-654-2445
Practice Address - Fax:813-654-9885
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS9221207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I17483Medicare UPIN
FLU3279YMedicare UPIN