Healthcare Provider Details

I. General information

NPI: 1710981048
Provider Name (Legal Business Name): RAUL HECTOR MARQUEZ-SARRAGA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CALLE WASHINGTON STE 702
SAN JUAN PR
00907-1521
US

IV. Provider business mailing address

PO BOX 16696
SAN JUAN PR
00908-6696
US

V. Phone/Fax

Practice location:
  • Phone: 787-725-6562
  • Fax:
Mailing address:
  • Phone: 787-725-6562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number8476
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: