Provider Demographics
NPI:1770261968
Name:MARQUEZ, JENILEE (RCMHCI)
Entity type:Individual
Prefix:
First Name:JENILEE
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:RCMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5013 SW 121ST TER
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4467
Mailing Address - Country:US
Mailing Address - Phone:347-725-9903
Mailing Address - Fax:
Practice Address - Street 1:7401 WILES RD STE 214
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2036
Practice Address - Country:US
Practice Address - Phone:954-283-0838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24686101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health