Provider Demographics
NPI:1396842845
Name:JULIAN MARQUEZ MD PA
Entity Type:Organization
Organization Name:JULIAN MARQUEZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-827-9939
Mailing Address - Street 1:2140 W 68TH ST
Mailing Address - Street 2:SUITE 401-A
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1815
Mailing Address - Country:US
Mailing Address - Phone:305-827-9939
Mailing Address - Fax:305-827-9918
Practice Address - Street 1:2140 W 68TH ST
Practice Address - Street 2:SUITE 401-A
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1815
Practice Address - Country:US
Practice Address - Phone:305-827-9939
Practice Address - Fax:305-827-9918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262837600Medicaid
FLK3419Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER