Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MA57030 | FL |
NPI | 1396050217 |
---|---|
Provider Name | Fernando J. Quesada |
First Address | Hialeah, FL 33010-4318 |
Second Address | Hialeah, FL 33010-4318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2010 |
Last Update Date | 16/08/2010 |