Provider Demographics
NPI:1780212381
Name:MARQUEZ, PATRICIA DEL CARMEN
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DEL CARMEN
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9160 NW 122ND ST UNIT #27
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018
Mailing Address - Country:US
Mailing Address - Phone:305-456-5710
Mailing Address - Fax:786-542-6092
Practice Address - Street 1:9160 NW 122ND ST UNIT #27
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018
Practice Address - Country:US
Practice Address - Phone:305-456-5710
Practice Address - Fax:786-542-6092
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41051183500000X
3336C0004X, 3336L0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Yes183500000XPharmacy Service ProvidersPharmacist
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy