Healthcare Provider Details

I. General information

NPI: 1588508964
Provider Name (Legal Business Name): IRIS QUINONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 411 KM 18.9 BO RIO GRANDE
AGUADA PR
00602
US

IV. Provider business mailing address

B5 PASEO DEL VALLE VISTA DEL PORTAL
ANASCO PR
00610
US

V. Phone/Fax

Practice location:
  • Phone: 787-252-2211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number003576
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: