Provider Demographics
NPI:1346374790
Name:MARQUEZ, ARMANDO JUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:JUAN
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:APARTADO 3247
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3247
Mailing Address - Country:US
Mailing Address - Phone:787-834-4770
Mailing Address - Fax:787-265-2120
Practice Address - Street 1:CALLE DR BASORA 16N
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-3247
Practice Address - Country:US
Practice Address - Phone:787-834-4770
Practice Address - Fax:787-265-2120
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7139174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR28894Medicare ID - Type Unspecified
PRC79796Medicare UPIN