Healthcare Provider Details

I. General information

NPI: 1356982730
Provider Name (Legal Business Name): QUINONES & SANCHEZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 EAGLES LANDING PKWY STE 105
STOCKBRIDGE GA
30281-5084
US

IV. Provider business mailing address

1273 METROPOLITAN AVE SE UNIT 17667
ATLANTA GA
30316-8009
US

V. Phone/Fax

Practice location:
  • Phone: 678-633-2877
  • Fax: 478-787-0006
Mailing address:
  • Phone: 678-633-2877
  • Fax: 478-787-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. PIA M BERKS
Title or Position: ADMINISTRATOR
Credential:
Phone: 770-378-2449