Provider Demographics
NPI:1245876564
Name:QUINONES, NATALIA
Entity type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:
Last Name:QUINONES
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 1:12311 KENSINGTON LAKES DR UNIT 3006
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-7199
Mailing Address - Country:US
Mailing Address - Phone:407-709-0677
Mailing Address - Fax:
Practice Address - Street 1:12735 GRAN BAY PKWY W STE 204
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-4499
Practice Address - Country:US
Practice Address - Phone:888-754-0398
Practice Address - Fax:954-982-6491
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-21
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-104620106S00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician