Provider Demographics
NPI:1184882953
Name:BELEN, MARIQUITA TOLENTINO (MD)
Entity type:Individual
Prefix:DR
First Name:MARIQUITA
Middle Name:TOLENTINO
Last Name:BELEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIQUITA IRENE
Other - Middle Name:SORIANO
Other - Last Name:TOLENTINO-BELEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2600 7TH ST SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710
Mailing Address - Country:US
Mailing Address - Phone:330-363-6242
Mailing Address - Fax:330-453-4263
Practice Address - Street 1:2600 7TH ST SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710
Practice Address - Country:US
Practice Address - Phone:330-363-6242
Practice Address - Fax:330-453-4263
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.121190207Q00000X
ORMD150766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine