Provider Demographics
NPI:1417004045
Name:MARQUES, ROMILIO FAUSTINO (MD)
Entity Type:Individual
Prefix:
First Name:ROMILIO
Middle Name:FAUSTINO
Last Name:MARQUES
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 1:4330 TAMIAMI TRL E
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-6756
Mailing Address - Country:US
Mailing Address - Phone:239-774-5437
Mailing Address - Fax:239-793-1918
Practice Address - Street 1:4330 TAMIAMI TRL E
Practice Address - Street 2:SUITE # 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-6756
Practice Address - Country:US
Practice Address - Phone:239-774-5437
Practice Address - Fax:239-793-1918
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75670208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254177700Medicaid