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General NPI Number Information
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NPI Number | 1508205121
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Entity Type | Individual
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Provider Name | ALEXANDRA DEYA QUINQUILLA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON STE 416
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City | SAN JUAN
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State | PR
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Zip | 00917-5026
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Country | US
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Telephone | 787-751-0373
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Fax | 787-858-0818
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Provider Business Mailing Address
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Address Line | 735 AVE PONCE DE LEON STE 416
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City | SAN JUAN
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State | PR
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Zip | 00917-5026
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Country | US
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Telephone | 787-751-0373
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Fax | 787-858-0818
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 19380
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 19380
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License Number State | PR
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