Provider Demographics
NPI:1063562346
Name:QUINONES MAYMI, DESIREE M (MD)
Entity type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:M
Last Name:QUINONES MAYMI
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:EXT. QUINTAS DE MONSERRATE
Mailing Address - Street 2:8 CALLE 6
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-1747
Mailing Address - Country:US
Mailing Address - Phone:787-671-8959
Mailing Address - Fax:
Practice Address - Street 1:2435 BLVD LUIS A FERRE
Practice Address - Street 2:HOSP. METROPOLITANO DR. PILA/DEPART. DE RADIOLOGIA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2112
Practice Address - Country:US
Practice Address - Phone:787-848-5600
Practice Address - Fax:787-842-9324
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR143022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH51963Medicare UPIN