Healthcare Provider Details

I. General information

NPI: 1386676369
Provider Name (Legal Business Name): STEVEN JEFFREY MARQUEZ BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 05/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11960 N LABYRINTH DR
ORO VALLEY AZ
85737-3453
US

IV. Provider business mailing address

PO BOX 91793
TUCSON AZ
85752-1793
US

V. Phone/Fax

Practice location:
  • Phone: 520-293-7736
  • Fax: 520-292-1362
Mailing address:
  • Phone: 520-292-1363
  • Fax: 520-292-1362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number21006543
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: