Provider Demographics
NPI:1811957749
Name:MARQUES, RICARDO
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:MARQUES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:MARQUES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:233 S FEDERAL HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-4938
Mailing Address - Country:US
Mailing Address - Phone:561-347-2996
Mailing Address - Fax:561-347-2998
Practice Address - Street 1:233 S FEDERAL HWY STE 103
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-4938
Practice Address - Country:US
Practice Address - Phone:561-347-2996
Practice Address - Fax:561-347-2998
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7185207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250200300Medicaid
FL57378Medicare ID - Type Unspecified
G33557Medicare UPIN