Provider Demographics
NPI:1013363993
Name:JUSINO QUINONES, EDWIN (OD)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:
Last Name:JUSINO QUINONES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLA DEL CARMEN
Mailing Address - Street 2:1045 CALLE SALERMO
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:956-706-8118
Mailing Address - Fax:
Practice Address - Street 1:PLAZA DEL CARIBE MALL
Practice Address - Street 2:2050 PONCE BYPASS SUITE 200
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-259-7059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR719152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy