Provider Demographics
NPI:1215459870
Name:AQUINO, LEONOR
Entity type:Individual
Prefix:
First Name:LEONOR
Middle Name:
Last Name:AQUINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE CAPETILLO 223
Mailing Address - Street 2:CAPETILLO RIO PIEDRAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925
Mailing Address - Country:US
Mailing Address - Phone:787-669-8638
Mailing Address - Fax:
Practice Address - Street 1:URB. RIO PIEDRAS HEIGHTS
Practice Address - Street 2:CALLE WEISSER #172
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-669-8638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19745208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice