Most Relevant Information
Provider Data
| NPI Number: | 1003336520 |
| Provider Name: | LARA QUESADA |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | SA15448 |
Most Important Dates
| Enumeration Date: | 06/26/2017 |
| Last Updated: | 06/26/2017 |
Provider Practice Location
4555 S MANHATTAN AVE
TAMPA
FL
336112305
Practice Location Phone/Fax
| Phone: | 8138396341 |
| Fax: |
Provider Mailing Location
101 5TH AVE SE
LUTZ
FL
335494332
Provider Mailing Phone/Fax
| Phone: | 8135034840 |
| Fax: |