MEDICARE: DR. SYED Z QUADRI D.M.D.

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	122300000X	Dentist	16822	FL

General Provider Information

NPI Number	:	1063487155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYED Z QUADRI D.M.D.

Provider Business Mailing Address
First Line	:	2090 PALM BAY RD NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-2913
Country	:	US
Telephone Number	:	321-984-2255
Fax Number	:	321-733-4441

Provider Business Practice Location Address
First Line	:	2090 PALM BAY RD NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-2913
Country	:	US
Telephone Number	:	321-984-2255
Fax Number	:	321-733-4441

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/16/2014

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