Provider Demographics
NPI:1952394835
Name:SCOFIELD MARQUES, SHARON SUE (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:SUE
Last Name:SCOFIELD MARQUES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:S
Other - Last Name:MARQUES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1475 WEST ORANGE BLOSSOM TRAIL
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712
Mailing Address - Country:US
Mailing Address - Phone:407-307-1041
Mailing Address - Fax:407-307-1039
Practice Address - Street 1:1475 WEST ORANGE BLOSSOM TRAIL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712
Practice Address - Country:US
Practice Address - Phone:407-307-1041
Practice Address - Fax:407-307-1039
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43801207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043152400Medicaid
FL043152400Medicaid
FL73306WMedicare PIN