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General NPI Number Information
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NPI Number | 1013363993
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Entity Type | Individual
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Provider Name | EDWIN JUSINO QUINONES OD
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Gender | Male
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | PLAZA DEL CARIBE MALL 2050 PONCE BYPASS SUITE 200
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City | PONCE
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State | PR
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Zip | 00717
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Country | US
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Telephone | 787-259-7059
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Fax |
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Provider Business Mailing Address
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Address Line | VILLA DEL CARMEN 1045 CALLE SALERMO
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 956-706-8118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 719
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License Number State | PR
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