Healthcare Provider Details

I. General information

NPI: 1114552544
Provider Name (Legal Business Name): DANISTER QUINONES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE PUBLICA & CARR 2
VEGA BAJA PR
00693
US

IV. Provider business mailing address

26 CALLE ITALIA
MANATI PR
00674-9804
US

V. Phone/Fax

Practice location:
  • Phone: 787-855-3044
  • Fax: 787-855-3301
Mailing address:
  • Phone: 787-346-4216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4143
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: