Provider Demographics
NPI:1750720116
Name:QUIMBY, ANASTASIYA (DDS; MD)
Entity type:Individual
Prefix:DR
First Name:ANASTASIYA
Middle Name:
Last Name:QUIMBY
Suffix:
Gender:F
Credentials:DDS; MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N FLAGLER DR STE 7600
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3419
Mailing Address - Country:US
Mailing Address - Phone:561-202-1070
Mailing Address - Fax:561-202-1075
Practice Address - Street 1:1411 N FLAGLER DR STE 7600
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3419
Practice Address - Country:US
Practice Address - Phone:561-202-1070
Practice Address - Fax:561-202-1075
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1450492086X0206X, 207YX0007X
FLDN216241223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017555900Medicaid