Provider Demographics
NPI:1003512484
Name:QUINONES, MAYVI (APRN)
Entity type:Individual
Prefix:
First Name:MAYVI
Middle Name:
Last Name:QUINONES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16502 SW 58TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5683
Mailing Address - Country:US
Mailing Address - Phone:305-632-2800
Mailing Address - Fax:
Practice Address - Street 1:5555 PONCE DE LEON BLVD STE 115
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2513
Practice Address - Country:US
Practice Address - Phone:305-689-0290
Practice Address - Fax:305-689-0927
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024387363LF0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily