Provider Demographics
NPI:1083648190
Name:MARQUEZ, FARID (PHYSICIAN/MD)
Entity Type:Individual
Prefix:DR
First Name:FARID
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:PHYSICIAN/MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 SW 42ND AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1751
Mailing Address - Country:US
Mailing Address - Phone:305-476-0244
Mailing Address - Fax:305-938-0852
Practice Address - Street 1:221 SW 42ND AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1751
Practice Address - Country:US
Practice Address - Phone:305-476-0244
Practice Address - Fax:305-938-0852
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0048235207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD50920Medicare UPIN
FL04076PMedicare PIN