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General NPI Number Information
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NPI Number | 1851711105
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Entity Type | Individual
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Provider Name | JAVIER QUINONES
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Gender | Male
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 9 CALLE J EXTENSION HERMANAS DAVILA
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City | BAYAMON
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State | PR
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Zip | 00960
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Country | US
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Telephone | 787-486-7682
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Fax |
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Provider Business Mailing Address
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Address Line | HC 06 BOX 13135
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City | COROZAL
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State | PR
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Zip | 00783
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Country | US
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Telephone |
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 1648
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License Number State | PR
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