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General NPI Number Information
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NPI Number | 1023972692
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Entity Type | Individual
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Provider Name | ROGER ALFREDO QUARANTA PA
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Gender | Male
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1400 MEADOWS BLVD
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City | WESTON
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State | FL
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Zip | 33327-1805
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Country | US
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Telephone | 305-497-6265
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 MEADOWS BLVD
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City | WESTON
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State | FL
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Zip | 33327-1805
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Country | US
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Telephone | 305-497-6265
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2984
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2984
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 21-558
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License Number State | FL
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