MEDICARE: EDUARDO QUESADA MD PA

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	207R00000X	Internal Medicine Physician	ME92714	FL

General Provider Information

NPI Number	:	1144454539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDUARDO QUESADA MD PA

Provider Business Mailing Address
First Line	:	11441 SW 104TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-3119
Country	:	US
Telephone Number	:	305-342-5249
Fax Number	:	305-275-9435

Provider Business Practice Location Address
First Line	:	11441 SW 104TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-3119
Country	:	US
Telephone Number	:	305-342-5249
Fax Number	:	305-275-9435

Authorized Official
Title or Position	:	PECIDENT
Name	:	DR. EDUARDO QUESADA
Credential	:	MD
Telephone Number	:	305-342-5249

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	05/13/2009

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