Healthcare Provider Details

I. General information

NPI: 1831018910
Provider Name (Legal Business Name): LUANNYS QUESADA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1759 W 56TH TER APT 308
HIALEAH FL
33012-2007
US

IV. Provider business mailing address

1759 W 56TH TER APT 308
HIALEAH FL
33012-2007
US

V. Phone/Fax

Practice location:
  • Phone: 786-614-1386
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: LUANNYS Z QUESADA CARVAJAL
Title or Position: OWNER
Credential:
Phone: 786-614-1386