Provider Demographics
NPI:1275597973
Name:MARQUEZ-BRITO, EYSA M (MD)
Entity Type:Individual
Prefix:
First Name:EYSA
Middle Name:M
Last Name:MARQUEZ-BRITO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:152 ALMERIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4515
Mailing Address - Country:US
Mailing Address - Phone:305-446-8377
Mailing Address - Fax:305-567-9126
Practice Address - Street 1:152 ALMERIA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6000
Practice Address - Country:US
Practice Address - Phone:305-446-8377
Practice Address - Fax:305-567-9126
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2014-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME471862080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE15786Medicare UPIN