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General NPI Number Information
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NPI Number | 1164090643
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Entity Type | Individual
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Provider Name | MR. ALEXIS MARQUEZ
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Gender | Male
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | CARROUSEL THERAPY CENTER 3201 BUDIGER AVENUE
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City | SAINT CLOUD
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State | FL
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Zip | 34769
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Country | US
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Telephone | 407-910-2941
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Fax |
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Provider Business Mailing Address
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Address Line | 3120 QUEEN ALEXANDRIA DR
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City | KISSIMMEE
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State | FL
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Zip | 34744-9108
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Country | US
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Telephone | 407-716-8943
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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