Provider Demographics
NPI:1972280451
Name:QUESADA PEREZ, DIANA R
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:R
Last Name:QUESADA PEREZ
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 1:5224 CURRY FORD RD APT 310
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-7010
Mailing Address - Country:US
Mailing Address - Phone:407-987-1671
Mailing Address - Fax:
Practice Address - Street 1:5224 CURRY FORD RD APT 310
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-7010
Practice Address - Country:US
Practice Address - Phone:407-987-1671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician