Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | GAA-NP000327 | GA |
NPI | 1316558299 |
---|---|
Provider Name | Isabel De-Quesada |
First Address | Fort Lauderdale, FL 33331-4609 |
Second Address | Atlanta, GA 30322-2134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2020 |
Last Update Date | 09/11/2021 |