Healthcare Provider Details

I. General information

NPI: 1467435123
Provider Name (Legal Business Name): ARIEL QUINONES RN
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE 65 INFANTERIA K-M 3.4 BARRIO SABANA LLANA
SAN JUAN PR
00924
US

IV. Provider business mailing address

CALLE 2 F22 BONNEVILLE TERRACE
CAGUAS PR
00725-5606
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-7676
  • Fax: 787-764-9904
Mailing address:
  • Phone: 787-310-1892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number1541
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: