Healthcare Provider Details

I. General information

NPI: 1962455147
Provider Name (Legal Business Name): KARINA QUINONES M.D., C.A.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CALLE FONT MARTELO E
HUMACAO PR
00791
US

IV. Provider business mailing address

PO BOX 9138
HUMACAO PR
00792-9138
US

V. Phone/Fax

Practice location:
  • Phone: 787-852-3114
  • Fax: 787-285-5642
Mailing address:
  • Phone: 787-852-3114
  • Fax: 787-285-5642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number17835
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: