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General NPI Number Information
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NPI Number | 1427597038
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Entity Type | Individual
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Provider Name | KENYA QUIALA
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Gender | Female
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 3201 BUDINGER AVE
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City | SAINT CLOUD
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State | FL
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Zip | 34769-7203
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Country | US
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Telephone | 407-910-2941
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Fax | 888-477-7678
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Provider Business Mailing Address
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Address Line | 2337 LILY PAD LN
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City | KISSIMMEE
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State | FL
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Zip | 34743-3653
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Country | US
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Telephone | 787-531-9119
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 11360
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License Number State | PR
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