Provider Demographics
NPI:1063487155
Name:QUADRI, SYED Z (DMD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:Z
Last Name:QUADRI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 PALM BAY RD NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-2913
Mailing Address - Country:US
Mailing Address - Phone:321-984-2255
Mailing Address - Fax:321-733-4441
Practice Address - Street 1:2090 PALM BAY RD NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2913
Practice Address - Country:US
Practice Address - Phone:321-984-2255
Practice Address - Fax:321-733-4441
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16822122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075998800Medicaid