Provider Demographics
NPI:1659474088
Name:DE QUESADA, EMILIO JR (MD)
Entity type:Individual
Prefix:
First Name:EMILIO
Middle Name:
Last Name:DE QUESADA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9725 NW 117TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1212
Mailing Address - Country:US
Mailing Address - Phone:954-432-0578
Mailing Address - Fax:954-432-5060
Practice Address - Street 1:12600 SW 120TH ST STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-9115
Practice Address - Country:US
Practice Address - Phone:305-506-1930
Practice Address - Fax:855-226-6633
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 82711207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108072700Medicaid
FLU4590YOtherMEDICARE