Provider Demographics
NPI:1740262591
Name:QUINONES, JOSE (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:QUINONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 S CONGRESS AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-7400
Mailing Address - Country:US
Mailing Address - Phone:561-737-1325
Mailing Address - Fax:561-737-4911
Practice Address - Street 1:2300 S CONGRESS AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7400
Practice Address - Country:US
Practice Address - Phone:561-737-1325
Practice Address - Fax:561-737-4911
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0043024174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61322Medicare ID - Type Unspecified
FLD55101Medicare UPIN