Provider Demographics
NPI:1053038836
Name:NIEVES QUINONES, KRISTINA MABEL (MD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MABEL
Last Name:NIEVES QUINONES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6100 BLUE LAGOON DR STE 365
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-7010
Mailing Address - Country:US
Mailing Address - Phone:786-322-7333
Mailing Address - Fax:786-322-7329
Practice Address - Street 1:9088 PROGRESS BLVD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4886
Practice Address - Country:US
Practice Address - Phone:813-444-0220
Practice Address - Fax:813-367-1961
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2024-02-13
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Provider Licenses
StateLicense IDTaxonomies
FLACN1597208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
16125-IOtherJUNTA DE LICENCIAMIENTO Y DISCIPLINA MEDICA DE PUERTO RICO
FLACN1597OtherMEDICAL LICENSE