Provider Demographics
NPI:1255532438
Name:MARQUEZ, ELVIN CASTRO SR (MD)
Entity type:Individual
Prefix:DR
First Name:ELVIN
Middle Name:CASTRO
Last Name:MARQUEZ
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ELVIN
Other - Middle Name:CASTRO
Other - Last Name:MARQUEZ
Other - Suffix:SR
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:#790 OSUNA LOS MAESTROS
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00923-2414
Mailing Address - Country:US
Mailing Address - Phone:787-748-7971
Mailing Address - Fax:787-748-7971
Practice Address - Street 1:790 OSUNA LOS MAESTROS
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00923-2414
Practice Address - Country:US
Practice Address - Phone:787-748-7971
Practice Address - Fax:787-748-7971
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9258174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist