Provider Demographics
NPI:1841912516
Name:QUINTO, JILL JULIANA (APRN)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:JULIANA
Last Name:QUINTO
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 1:1842 CROSSROADS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-8220
Mailing Address - Country:US
Mailing Address - Phone:248-840-1292
Mailing Address - Fax:
Practice Address - Street 1:3480 POLYNESIAN ISLE BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-4654
Practice Address - Country:US
Practice Address - Phone:407-507-2615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily