Provider Demographics
NPI:1306065461
Name:QUINONES, ANGEL L (PT)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:L
Last Name:QUINONES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 GILLIAN DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-9304
Mailing Address - Country:US
Mailing Address - Phone:352-754-2848
Mailing Address - Fax:
Practice Address - Street 1:21905 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2342
Practice Address - Country:US
Practice Address - Phone:727-669-4245
Practice Address - Fax:727-669-6835
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT8524225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist