Provider Demographics
NPI:1386084085
Name:QUINRO ENTERPRISES LLC
Entity type:Organization
Organization Name:QUINRO ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:RODDENBERRY
Authorized Official - Last Name:QUINTANILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-249-1257
Mailing Address - Street 1:4224 W GULF TO LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-9215
Mailing Address - Country:US
Mailing Address - Phone:352-249-1257
Mailing Address - Fax:352-249-1260
Practice Address - Street 1:4224 W GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-9215
Practice Address - Country:US
Practice Address - Phone:352-249-1257
Practice Address - Fax:352-249-1260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230036253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care