Provider Demographics
NPI:1912373994
Name:O'QUINN, ROBERT C JR (MS, ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:O'QUINN
Suffix:JR
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 REFLECTIONS LOOP E
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-3567
Mailing Address - Country:US
Mailing Address - Phone:316-655-3716
Mailing Address - Fax:
Practice Address - Street 1:1201 N SCENIC HWY
Practice Address - Street 2:
Practice Address - City:BABSON PARK
Practice Address - State:FL
Practice Address - Zip Code:33827-9751
Practice Address - Country:US
Practice Address - Phone:863-638-1431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 43072255A2300X
KS24-008922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer