Provider Demographics
NPI:1932970001
Name:QUILES COLON, GENOVA ZENAIDA
Entity type:Individual
Prefix:
First Name:GENOVA
Middle Name:ZENAIDA
Last Name:QUILES COLON
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 1:206 REENA DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-0065
Mailing Address - Country:US
Mailing Address - Phone:787-901-6175
Mailing Address - Fax:
Practice Address - Street 1:206 REENA DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-0065
Practice Address - Country:US
Practice Address - Phone:787-901-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor