Individual
IVO LAZARO QUINONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5555 PONCE DE LEON BLVD, CORAL GABLES, FL 33146-2513
(305) 284-9100
(305) 284-4098
Mailing address
5555 PONCE DE LEON BLVD, CORAL GABLES, FL 33146-2513
(305) 284-9100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9115065
FL
363AM0700X
Medical Physician Assistant
Primary
PA9115065
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113137200
—
FL
Enumeration date
09/30/2021
Last updated
08/03/2022
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