Provider Demographics
NPI:1417934217
Name:QUINONEZ, LESTER (MD)
Entity type:Individual
Prefix:DR
First Name:LESTER
Middle Name:
Last Name:QUINONEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 319
Mailing Address - Street 2:
Mailing Address - City:LOIZA
Mailing Address - State:PR
Mailing Address - Zip Code:00772-0319
Mailing Address - Country:US
Mailing Address - Phone:787-363-1473
Mailing Address - Fax:954-318-6599
Practice Address - Street 1:METRO PARVIA CLINIC CAROLINA- EMERGENCY ROOM
Practice Address - Street 2:KM 13.3 CARR #3
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:561-967-2334
Practice Address - Fax:561-967-8256
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14385208D00000X
FLACN608207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJ2YZYOtherBCBS
FLIK852ZMedicare UPIN