Healthcare Provider Details

I. General information

NPI: 1649249467
Provider Name (Legal Business Name): JOSE TITO LIMA QUINONES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 LLOVERAS ST STE 101, EDIFICIO CENTRO PLAZA
SAN JUAN PR
00909
US

IV. Provider business mailing address

PO BOX 16080
SAN JUAN PR
00908-6080
US

V. Phone/Fax

Practice location:
  • Phone: 787-725-0360
  • Fax: 787-721-4555
Mailing address:
  • Phone: 787-725-0360
  • Fax: 787-721-4555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number11017
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number11017
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: