MEDICARE: MS. MICHELLE A QUINONES RDN,LDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	12438	FL

General Provider Information

NPI Number	:	1083493373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE A QUINONES RDN,LDN

Provider Business Mailing Address
First Line	:	13005 NE 4TH AVE
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-4654
Country	:	US
Telephone Number	:	305-467-3699
Fax Number	:

Provider Business Practice Location Address
First Line	:	13005 NE 4TH AVE
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-4654
Country	:	US
Telephone Number	:	305-467-3699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2023
Last Update Date	:	09/26/2023

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