=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588590384
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELOY JOSE QUESADA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2026
-----------------------------------------------------
Last Update Date | 06/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2400 N ORANGE BLOSSOM TRL STE 201
-----------------------------------------------------
City | KISSIMMEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34744-2307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-933-6684
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5005 CAPE HATTERAS DR
-----------------------------------------------------
City | CLERMONT
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34714-5296
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-213-7756
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number | 39915
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------