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NPI Code Detail

MEDICARE: DR. JONATHAN ALEXANDER QUINONEZ D.O

MEDICARE: DR. JONATHAN ALEXANDER QUINONEZ D.O
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
1207QA0401XAddiction Medicine (Family Medicine) PhysicianOS16342FL
2208D00000XGeneral Practice PhysicianOS16342FL
3204D00000XNeuromusculoskeletal Medicine & OMM PhysicianOS16342FL

Other Identifiers

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

General Provider Information

NPI Number : 1679013437
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN ALEXANDER QUINONEZ D.O
Provider Business Mailing Address
First Line : 12012 BOYETTE RD
Second Line :
City : RIVERVIEW
State : FL
Zip : 33569-5631
Country : US
Telephone Number : 813-295-7762
Fax Number :
Provider Business Practice Location Address
First Line : 12012 BOYETTE RD
Second Line :
City : RIVERVIEW
State : FL
Zip : 33569-5631
Country : US
Telephone Number : 813-295-7762
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2017
Last Update Date : 05/16/2025

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