Provider Demographics
NPI:1891450441
Name:QUESADA REYES, YOANDRA LUISA
Entity Type:Individual
Prefix:
First Name:YOANDRA
Middle Name:LUISA
Last Name:QUESADA REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 NW 116TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1964
Mailing Address - Country:US
Mailing Address - Phone:786-395-6460
Mailing Address - Fax:
Practice Address - Street 1:8851 NW 116TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1964
Practice Address - Country:US
Practice Address - Phone:786-395-6460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health