Provider Demographics
NPI:1558620476
Name:ORDONEZ, MARCOS ANTONIO (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:ANTONIO
Last Name:ORDONEZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4567 HOLLY DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4501
Mailing Address - Country:US
Mailing Address - Phone:561-827-2262
Mailing Address - Fax:
Practice Address - Street 1:4567 HOLLY DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-4501
Practice Address - Country:US
Practice Address - Phone:561-827-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-12
Last Update Date:2012-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist