Provider Demographics
NPI:1114552544
Name:QUINONES, DANISTER (PHD)
Entity type:Individual
Prefix:DR
First Name:DANISTER
Middle Name:
Last Name:QUINONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CALLE ITALIA
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-9804
Mailing Address - Country:US
Mailing Address - Phone:787-346-4216
Mailing Address - Fax:
Practice Address - Street 1:CALLE PUBLICA & CARR 2
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-855-3044
Practice Address - Fax:787-855-3301
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4143183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist