Provider Demographics
NPI:1366046690
Name:QUINONES, ARNALDO JESUS
Entity type:Individual
Prefix:
First Name:ARNALDO
Middle Name:JESUS
Last Name:QUINONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10237 NW 9TH STREET CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3239
Mailing Address - Country:US
Mailing Address - Phone:786-624-1571
Mailing Address - Fax:
Practice Address - Street 1:10237 NW 9TH STREET CIR APT 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-3239
Practice Address - Country:US
Practice Address - Phone:786-624-1571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ552-010-71-388-0Medicaid