Ediely Quiros Gaetan

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

8665 Issued in FL

Practice address

782 Foxridge Center Dr
Orange Park, FL 32065-5776

Phone

(904) 538-0713

Fax

(904) 538-0714

NPI assigned

Sep 18, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ediely Quiros Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1831618107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 903",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566755",
            "telephone_number": "904-538-0713",
            "fax_number": "904-538-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "782 FOXRIDGE CENTER DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320655776",
            "telephone_number": "904-538-0713",
            "fax_number": "904-538-0714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6816 Southpoint Pkwy Ste 500",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322161702",
            "country_code": "US",
            "telephone_number": "904-538-0713 x1120",
            "fax_number": "904-538-0714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUIROS GAETAN",
        "first_name": "EDIELY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "8665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDIELY",
            "last_name": "QUIROS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zachary Pitt Purvis, DO
• Quality Care of FL.Inc
• Emma Caroline Queener, RBT
• Lazaro Jesus Quintana Pardo
• Tara Quinton, MPT
• R K Vishen MD P a
• Memona Rafiq, M.D.
• Mary Ragusa, PTA
• Kiana Rahimi, MD
• Natalia Michelle Raimundi Santos

• Behavior Analyst in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.