Provider Demographics
NPI:1760869226
Name:MARQUETTI, RICARDO (DC)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:
Last Name:MARQUETTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CALLE EARLE APT 1101
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1264
Mailing Address - Country:US
Mailing Address - Phone:787-529-4111
Mailing Address - Fax:787-294-5481
Practice Address - Street 1:1407 AVE ASHFORD
Practice Address - Street 2:STE. 1B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1452
Practice Address - Country:US
Practice Address - Phone:787-529-4111
Practice Address - Fax:787-294-5481
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0534111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician