Provider Demographics
NPI:1740526177
Name:MARQUEZ, GABRIELA ELEONORA (DDS)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:ELEONORA
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 US HIGHWAY 41 BYP S
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-4748
Mailing Address - Country:US
Mailing Address - Phone:941-484-8481
Mailing Address - Fax:
Practice Address - Street 1:1301 PLANTATION ISLAND DR S STE 204
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-3111
Practice Address - Country:US
Practice Address - Phone:904-794-1824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN199991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice