Provider Demographics
NPI:1912247768
Name:MARQUES, HECTOR JOSHUA (OTA 12583)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:JOSHUA
Last Name:MARQUES
Suffix:
Gender:M
Credentials:OTA 12583
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 W 41ST ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4433
Mailing Address - Country:US
Mailing Address - Phone:305-761-1155
Mailing Address - Fax:
Practice Address - Street 1:91 W 41ST ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4433
Practice Address - Country:US
Practice Address - Phone:305-761-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 12583224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant