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General NPI Number Information
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NPI Number | 1811011588
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Entity Type | Organization
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Legal Business Name | JUAN C QUEROL MD PA
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 5801 NW 151ST ST SUITE 306
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2476
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Country | US
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Telephone | 305-698-0452
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Fax | 305-698-0476
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Provider Business Mailing Address
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Address Line | PO BOX 172286
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City | HIALEAH
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State | FL
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Zip | 33017-2286
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Country | US
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Telephone | 305-698-0452
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Fax | 305-698-0476
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Authorized Official
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Title or Position | MDPA
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Name | DR. JUAN C QUEROL
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Credential | M.D
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Telephone | 305-698-0452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME68841
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License Number State | FL
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