Provider Demographics
NPI:1942305255
Name:MARQUEZ MEDICAL SUPPLY,INC
Entity Type:Organization
Organization Name:MARQUEZ MEDICAL SUPPLY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-942-5704
Mailing Address - Street 1:4038 NW 181ST LN
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3451
Mailing Address - Country:US
Mailing Address - Phone:786-942-5704
Mailing Address - Fax:
Practice Address - Street 1:4038 NW 181ST LN
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33055-3451
Practice Address - Country:US
Practice Address - Phone:786-942-5704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies