Provider Demographics
NPI:1699519462
Name:THORNTON, QUASHONDA MAKEYSHIA
Entity type:Individual
Prefix:
First Name:QUASHONDA
Middle Name:MAKEYSHIA
Last Name:THORNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MAGUIRE PARK ST APT 300
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4932
Mailing Address - Country:US
Mailing Address - Phone:689-230-4454
Mailing Address - Fax:
Practice Address - Street 1:800 MAGUIRE PARK ST APT 300
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4932
Practice Address - Country:US
Practice Address - Phone:689-230-4454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide