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NPI Code Detail

MEDICARE: JORGE M QUINONEZ M.D.

MEDICARE: JORGE M QUINONEZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianME87619FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
216297YOTHERFLMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578554218
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE M QUINONEZ M.D.
Provider Business Mailing Address
First Line : PO BOX 919771
Second Line :
City : ORLANDO
State : FL
Zip : 32891-9771
Country : US
Telephone Number : 239-278-3600
Fax Number : 239-226-4650
Provider Business Practice Location Address
First Line : 2232 GRAND AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-3717
Country : US
Telephone Number : 239-344-2341
Fax Number : 239-278-3203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 09/30/2020

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Directions to “ JORGE M QUINONEZ M.D.” Practice Location

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