Individual
BENITO QUEZADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
251 OLD KENT CIRCLE KISSIMMEE FL 34758, KISSIMMEE, FL 34758
(347) 748-0029
Mailing address
1330 INTERVALE AVE APT 5S, BRONX, NY 10459-1185
(347) 307-3189
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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