MEDICARE: DR. ANAMARY QUIROS MESA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	76457	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043292105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANAMARY QUIROS MESA MD

Provider Business Mailing Address
First Line	:	12101 PINE NEEDLE LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-5722
Country	:	US
Telephone Number	:	786-371-4130
Fax Number	:

Provider Business Practice Location Address
First Line	:	1545 SAN REMO AVE
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-3008
Country	:	US
Telephone Number	:	305-403-4930
Fax Number	:	305-403-4940

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	08/14/2008

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