Healthcare Provider Details

I. General information

NPI: 1659204816
Provider Name (Legal Business Name): JOSE ALEJANDRO QUINONES NEGRON SR. CPL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 66 BOX 5326
FAJARDO PR
00738-9027
US

IV. Provider business mailing address

HC 66 BOX 5326
FAJARDO PR
00738-9027
US

V. Phone/Fax

Practice location:
  • Phone: 787-365-2882
  • Fax:
Mailing address:
  • Phone: 787-365-2882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4893
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: