Healthcare Provider Details

I. General information

NPI: 1225052087
Provider Name (Legal Business Name): JAMES LEE QUINLAN DNP, ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 N. MAIN STREET
WILLISTON FL
32696-2136
US

IV. Provider business mailing address

223 N. MAIN STREET
WILLISTON FL
32696-2136
US

V. Phone/Fax

Practice location:
  • Phone: 352-529-0477
  • Fax: 352-529-0406
Mailing address:
  • Phone: 352-529-0477
  • Fax: 352-529-0406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP2536632
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: