Healthcare Provider Details

I. General information

NPI: 1417861485
Provider Name (Legal Business Name): ROXANA QUINONES LMFT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 S UNIVERSITY DR STE 308
DAVIE FL
33328-5310
US

IV. Provider business mailing address

9400 LIVE OAK PL APT 203
DAVIE FL
33324-4708
US

V. Phone/Fax

Practice location:
  • Phone: 954-378-5381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: