Healthcare Provider Details

I. General information

NPI: 1871676551
Provider Name (Legal Business Name): PAT QUIJADA, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 BELLEVUE AVE SUITE 102
ORLANDO FL
32806-2933
US

IV. Provider business mailing address

1802 BELLEVUE AVE SUITE 102
ORLANDO FL
32806-2933
US

V. Phone/Fax

Practice location:
  • Phone: 407-843-2967
  • Fax:
Mailing address:
  • Phone: 407-843-2967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME25243
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberME25243
License Number StateFL

VIII. Authorized Official

Name: DR. PATRICIO B. QUIJADA
Title or Position: OWNER
Credential: M.D.
Phone: 407-843-2967