Healthcare Provider Details

I. General information

NPI: 1891347050
Provider Name (Legal Business Name): MICHAEL MARQUIS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2964 N STATE ROAD 7 STE 205
MARGATE FL
33063-5718
US

IV. Provider business mailing address

2825 N STATE ROAD 7 STE 204
MARGATE FL
33063-5737
US

V. Phone/Fax

Practice location:
  • Phone: 954-580-4080
  • Fax: 954-580-4081
Mailing address:
  • Phone: 954-580-4080
  • Fax: 954-530-5096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: