Provider Demographics
NPI:1033280987
Name:MARQUEZ, SALVADOR (MD)
Entity Type:Individual
Prefix:
First Name:SALVADOR
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB CAMBRIDGE PARK
Mailing Address - Street 2:PLAZA 12 D-7
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2229
Mailing Address - Country:US
Mailing Address - Phone:787-758-8351
Mailing Address - Fax:787-758-8351
Practice Address - Street 1:AVE PONCE DE LEON
Practice Address - Street 2:HOSPTIAL AUXILLO MUTUO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919-1227
Practice Address - Country:US
Practice Address - Phone:787-758-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3318207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E00123Medicare UPIN
PRMA23570Medicare ID - Type Unspecified