Provider Demographics
NPI:1730996307
Name:QUINONES, ANGEL RAPHAEL
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:RAPHAEL
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 1:111 GARFIELD PL APT 1208
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1944
Mailing Address - Country:US
Mailing Address - Phone:216-926-7064
Mailing Address - Fax:
Practice Address - Street 1:111 GARFIELD PL APT 1208
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1944
Practice Address - Country:US
Practice Address - Phone:216-926-7064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program