Provider Demographics
NPI:1891853156
Name:MARQUIT, JUDITH B (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:B
Last Name:MARQUIT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 NORTH FLAMINGO RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028
Mailing Address - Country:US
Mailing Address - Phone:954-432-6340
Mailing Address - Fax:954-438-4620
Practice Address - Street 1:601 NORTH FLAMINGO RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028
Practice Address - Country:US
Practice Address - Phone:954-432-6340
Practice Address - Fax:954-438-4620
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3315103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
229261OtherCOMP PSYCH
CIGNAOther64801
210439OtherMAGELLAN
75393OtherBCBS
092734OtherVALUE OPTIONS
81963OtherFIRST HEALTH
29881OtherCORPEHEALTH
210439OtherMAGELLAN
CIGNAOther64801