Provider Demographics
NPI:1144454539
Name:EDUARDO QUESADA MD PA
Entity type:Organization
Organization Name:EDUARDO QUESADA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PECIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:QUESADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-342-5249
Mailing Address - Street 1:11441 SW 104TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3119
Mailing Address - Country:US
Mailing Address - Phone:305-342-5249
Mailing Address - Fax:305-275-9435
Practice Address - Street 1:11441 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-3119
Practice Address - Country:US
Practice Address - Phone:305-342-5249
Practice Address - Fax:305-275-9435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92714207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty