Individual
AIDA LUCIA QUESADA-GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7780 BRIDGES ST, JACKSONVILLE, FL 32216-5881
(203) 444-6980
Mailing address
7780 BRIDGES ST, JACKSONVILLE, FL 32216-5881
(203) 444-6980
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
10/31/2011
Last updated
04/27/2017
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