Provider Demographics
NPI:1912609900
Name:QUINONEZ, MARIA SOFIA (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SOFIA
Last Name:QUINONEZ
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 N OLA AVE UNIT 316
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-2022
Mailing Address - Country:US
Mailing Address - Phone:239-410-3917
Mailing Address - Fax:
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:FLOOR 3
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4804
Practice Address - Country:US
Practice Address - Phone:727-767-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11025317363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL118059800Medicaid
FL5BX0OOtherBLUE CROSS BLUE SHIELD