Provider Demographics
NPI:1639476021
Name:QUESADA, ROCIO (MS, SLP)
Entity Type:Individual
Prefix:
First Name:ROCIO
Middle Name:
Last Name:QUESADA
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 CYPRESS TRCE
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4960
Mailing Address - Country:US
Mailing Address - Phone:561-386-3986
Mailing Address - Fax:
Practice Address - Street 1:199 CYPRESS TRCE
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4960
Practice Address - Country:US
Practice Address - Phone:561-386-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11570235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018800900Medicaid
FL018800300Medicaid