Healthcare Provider Details

I. General information

NPI: 1396871273
Provider Name (Legal Business Name): XIOMARA QUINONES VARGAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 N SEMORAN BLVD
ORLANDO FL
32807-3350
US

IV. Provider business mailing address

672 N SEMORAN BLVD
ORLANDO FL
32807-3350
US

V. Phone/Fax

Practice location:
  • Phone: 689-339-0900
  • Fax: 321-320-8950
Mailing address:
  • Phone: 689-339-0900
  • Fax: 321-320-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN1061
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: