Healthcare Provider Details

I. General information

NPI: 1346224318
Provider Name (Legal Business Name): RUBEN MARQUEZ MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 ROAD #2, SUITE 609
BAYAMON PR
00959-7200
US

IV. Provider business mailing address

PO BOX 8205
BAYAMON PR
00960-8205
US

V. Phone/Fax

Practice location:
  • Phone: 787-269-2004
  • Fax: 787-269-2004
Mailing address:
  • Phone: 787-269-2004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8432
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: