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General NPI Number Information
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NPI Number | 1942431119
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Entity Type | Organization
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Legal Business Name | GONZALO QUESADA, MD, PA
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 08/05/2009
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Provider Practice Location Address
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Address Line | 2000 S DIXIE HWY SUITE 103
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City | MIAMI
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State | FL
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Zip | 33133-2456
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Country | US
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Telephone | 305-285-8900
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Fax | 305-285-1462
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Provider Business Mailing Address
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Address Line | 2000 S DIXIE HWY SUITE 103
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City | MIAMI
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State | FL
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Zip | 33133-2456
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Country | US
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Telephone | 305-285-8900
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Fax | 305-285-1462
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GONZALO F QUESADA
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Credential | MD
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Telephone | 305-285-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME84185
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License Number State | FL
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