Provider Demographics
NPI:1619217528
Name:QUESADA, ALICIA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:QUESADA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8570 SW 27TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2349
Mailing Address - Country:US
Mailing Address - Phone:786-663-4799
Mailing Address - Fax:
Practice Address - Street 1:8570 SW 27TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2349
Practice Address - Country:US
Practice Address - Phone:786-663-4799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH15942124Q00000X
FLRN9288870163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
No163W00000XNursing Service ProvidersRegistered Nurse