Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | AL3032 | FL |
Y | 213ES0000X | Sports Medicine | AL3032 | FL |
NPI | 1194298216 |
---|---|
Provider Name | Courtney Quinn |
First Address | Orlando, FL 32810-6085 |
Second Address | Orlando, FL 32810-6085 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2019 |
Last Update Date | 11/01/2019 |