Provider Demographics
NPI:1447982186
Name:QUINONES, EVER ISAAC (BCBA)
Entity type:Individual
Prefix:
First Name:EVER
Middle Name:ISAAC
Last Name:QUINONES
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 SW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-4600
Mailing Address - Country:US
Mailing Address - Phone:305-972-9892
Mailing Address - Fax:
Practice Address - Street 1:8950 SW 74TH CT STE 2100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3171
Practice Address - Country:US
Practice Address - Phone:800-368-2143
Practice Address - Fax:561-412-1788
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114790100Medicaid