Healthcare Provider Details

I. General information

NPI: 1750677860
Provider Name (Legal Business Name): ELIZABETH J MARQUEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13241 BARTRAM PARK BLVD UNIT 905
JACKSONVILLE FL
32258-5217
US

IV. Provider business mailing address

13241 BARTRAM PARK BLVD UNIT 905
JACKSONVILLE FL
32258-5217
US

V. Phone/Fax

Practice location:
  • Phone: 904-822-7827
  • Fax: 904-325-7991
Mailing address:
  • Phone: 904-822-7827
  • Fax: 904-325-7991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME117715
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: