Basic Information
| Provider Information | |||||||||
| NPI: | 1780652727 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUERAL | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | ANIBAL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 911 MALAGA AVE | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331346414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104400454 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7150 W 20TH AVE | ||||||||
| Address2: | SUITE 501 | ||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330165529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058213999 | ||||||||
| FaxNumber: | 3058213666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 10/14/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | ME 118298 | FL | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 2086S0129X | DOO17095 | MD | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.