Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME106124 | FL |
Y | 208600000X | Surgeon | ME106124 | FL |
N | 208200000X | Surgeon | RQ075615 | MI |
N | 208600000X | Surgeon | RQ075615 | MI |
N | 2086S0129X | Vascular Surgeon | ME106124 | FL |
NPI | 1013929439 |
---|---|
Provider Name | Dr. Rafael Quinones |
First Address | Tampa, FL 33624-1871 |
Second Address | Port St Lucie, FL 34986-2212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 15/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E10360 | (02) | FL |