Provider Demographics
NPI:1285112375
Name:NIEVES QUINONES, ORLANDO SR (LGSW)
Entity type:Individual
Prefix:MR
First Name:ORLANDO
Middle Name:
Last Name:NIEVES QUINONES
Suffix:SR
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2649 CARR 459
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:PR
Mailing Address - Zip Code:00690-1276
Mailing Address - Country:US
Mailing Address - Phone:787-579-7967
Mailing Address - Fax:787-931-0548
Practice Address - Street 1:CARR 107 KM 0.7
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-229-2222
Practice Address - Fax:787-931-0548
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR70961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7096OtherSTATE LICENSED SOCIAL WORKER NUMBER