Provider Demographics
NPI:1588797849
Name:LOURDES A MARQUEZ AND CRISTINA ANDIA RABO PTR
Entity Type:Organization
Organization Name:LOURDES A MARQUEZ AND CRISTINA ANDIA RABO PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-372-7992
Mailing Address - Street 1:5409 AVE O
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FT MADISON
Mailing Address - State:IA
Mailing Address - Zip Code:52627
Mailing Address - Country:US
Mailing Address - Phone:319-372-7992
Mailing Address - Fax:319-372-9641
Practice Address - Street 1:5409 AVE O
Practice Address - Street 2:SUITE 120
Practice Address - City:FT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627
Practice Address - Country:US
Practice Address - Phone:319-372-7992
Practice Address - Fax:319-372-9641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA14128OtherBCBS
IA0141283Medicare ID - Type Unspecified