Healthcare Provider Details

I. General information

NPI: 1992688436
Provider Name (Legal Business Name): AMAURY RAMON MARCE QUIANS PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 SE 15TH PL APT 2
CAPE CORAL FL
33990-4522
US

IV. Provider business mailing address

1805 SE 15TH PL APT 2
CAPE CORAL FL
33990-4522
US

V. Phone/Fax

Practice location:
  • Phone: 910-631-3413
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2791
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-456513
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: