Provider Demographics
NPI:1154684298
Name:MARQUEZ, ANDRE JOSE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:JOSE
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 CARR. 165 CENTRO INTERNACIONAL DE COMERCIO
Mailing Address - Street 2:SUITE 303
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:404-917-7775
Mailing Address - Fax:787-277-0847
Practice Address - Street 1:100 CARR. 165 CENTRO INTERNACIONAL DE COMERCIO
Practice Address - Street 2:SUITE 303
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968
Practice Address - Country:US
Practice Address - Phone:404-917-7775
Practice Address - Fax:787-277-0847
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009002111N00000X
PR518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor