Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME80428 | FL |
Y | 111NI0900X | Internist | ME80428 | FL |
N | 207RG0300X | Geriatric Medicine | ME80428 | FL |
NPI | 1124023239 |
---|---|
Provider Name | Dr. Gerardo Quinonez |
First Address | Boynton Beach, FL 33426-6346 |
Second Address | Boynton Beach, FL 33426-6346 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 19/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
264184400 | (05) | FL |
H13973 | (02) | FL |