Provider Demographics
NPI:1386676369
Name:MARQUEZ, STEVEN JEFFREY (BS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JEFFREY
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 91793
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85752-1793
Mailing Address - Country:US
Mailing Address - Phone:520-292-1363
Mailing Address - Fax:520-292-1362
Practice Address - Street 1:11960 N LABYRINTH DR
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-3453
Practice Address - Country:US
Practice Address - Phone:520-293-7736
Practice Address - Fax:520-292-1362
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2017-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224Y00000X, 332BC3200X
AZ21006543332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ563892Medicaid
AZ563892Medicaid
AZ1301760001Medicare NSC