Provider Demographics
NPI:1174088215
Name:QUINONES, JOSE ANGEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE ANGEL
Middle Name:
Last Name:QUINONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:J22 SUITE 4 CALLE MYRNA, LEVITTOWN
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3128
Mailing Address - Country:US
Mailing Address - Phone:939-264-4822
Mailing Address - Fax:
Practice Address - Street 1:J22 SUITE 4 CALLE MYRNA
Practice Address - Street 2:LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3128
Practice Address - Country:US
Practice Address - Phone:939-264-4822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-03
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21209208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice