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General NPI Number Information
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NPI Number | 1083210934
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Entity Type | Individual
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Provider Name | RAUL MANUEL MARQUEZ JR. PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 4610 S UNIVERSITY DR
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City | DAVIE
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State | FL
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Zip | 33328-3818
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Country | US
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Telephone | 954-434-2002
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Fax |
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Provider Business Mailing Address
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Address Line | 1912 SW 17TH AVE APT 20
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City | MIAMI
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State | FL
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Zip | 33145-2766
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Country | US
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Telephone | 786-253-3351
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS60783
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License Number State | FL
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