Healthcare Provider Details

I. General information

NPI: 1417004045
Provider Name (Legal Business Name): ROMILIO FAUSTINO MARQUES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 TAMIAMI TRL E SUITE # 200
NAPLES FL
34112-6756
US

IV. Provider business mailing address

4330 TAMIAMI TRL E SUITE # 200
NAPLES FL
34112-6756
US

V. Phone/Fax

Practice location:
  • Phone: 239-774-5437
  • Fax: 239-793-1918
Mailing address:
  • Phone: 239-774-5437
  • Fax: 239-793-1918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME75670
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: