Provider Demographics
NPI:1518939545
Name:QUESADA ALONSO, ANGEL JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:JOSE
Last Name:QUESADA ALONSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PARKVILLE SUR CLEVELAND E 13
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-720-1011
Mailing Address - Fax:787-860-8178
Practice Address - Street 1:AVE GENERAL VALERO 303
Practice Address - Street 2:SUITE 204 EDITICIO MEDICO DEL ESTE
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-860-8178
Practice Address - Fax:787-860-8178
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8851207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR81618QUOtherTRIPLE SSS
PR81618QUOtherTRIPLE SSS
PR81618Medicare ID - Type Unspecified