Healthcare Provider Details

I. General information

NPI: 1275197451
Provider Name (Legal Business Name): AMBER JEANETTE QUINONES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR UNIT MEDDAC
FORT CARSON CO
80913-4604
US

IV. Provider business mailing address

2559 MEDICAL DRIVE SUITE D
ALAMOGORDO NM
88310
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD2022-1048
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0074823
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: