Provider Demographics
NPI:1750125357
Name:MARQUES, NELSON (RD)
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:
Last Name:MARQUES
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 E EAU GALLIE BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4242
Mailing Address - Country:US
Mailing Address - Phone:201-388-4444
Mailing Address - Fax:
Practice Address - Street 1:944 S STADIUM DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-4019
Practice Address - Country:US
Practice Address - Phone:201-388-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics