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General NPI Number Information
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NPI Number | 1659474088
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Entity Type | Individual
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Provider Name | EMILIO DE QUESADA JR. MD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 12600 SW 120TH ST STE 101
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City | MIAMI
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State | FL
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Zip | 33186-9115
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Country | US
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Telephone | 305-506-1930
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Fax | 855-226-6633
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Provider Business Mailing Address
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Address Line | 9725 NW 117TH AVE FL 2
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City | MEDLEY
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State | FL
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Zip | 33178-1212
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Country | US
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Telephone | 954-432-0578
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Fax | 954-432-5060
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME 82711
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License Number State | FL
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