Provider Demographics
NPI:1881757599
Name:QUINONES, JACOBO E (MD)
Entity type:Individual
Prefix:DR
First Name:JACOBO
Middle Name:E
Last Name:QUINONES
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:187 CALLE SERENIDAD
Mailing Address - Street 2:PARAISO DE MAYAGUEZ
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6217
Mailing Address - Country:US
Mailing Address - Phone:787-892-1860
Mailing Address - Fax:787-892-2302
Practice Address - Street 1:CARR #2 KM. 173.4 BO. CAIN ALTO
Practice Address - Street 2:TORRE MEDICA SAN VICENTE DE PAUL SUITE 303
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-1860
Practice Address - Fax:787-892-2302
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13577207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH93576Medicare UPIN
PR0021754Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER