Healthcare Provider Details

I. General information

NPI: 1275597973
Provider Name (Legal Business Name): EYSA M. MARQUEZ-BRITO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 12/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 ALMERIA AVE
CORAL GABLES FL
33134-6000
US

IV. Provider business mailing address

152 ALMERIA AVENUE
CORAL GABLES FL
33134-4515
US

V. Phone/Fax

Practice location:
  • Phone: 305-446-8377
  • Fax: 305-567-9126
Mailing address:
  • Phone: 305-446-8377
  • Fax: 305-567-9126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberME47186
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: