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General NPI Number Information
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NPI Number | 1730546565
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Entity Type | Organization
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Legal Business Name | OTTO MARQUEZ MD PA
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 13801 SW 34TH ST
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City | MIAMI
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State | FL
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Zip | 33175-7210
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Country | US
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Telephone | 305-431-1376
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Fax | 305-470-1853
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Provider Business Mailing Address
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Address Line | 13801 SW 34TH ST
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City | MIAMI
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State | FL
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Zip | 33175-7210
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Country | US
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Telephone | 305-431-1376
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Fax | 305-470-1853
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Authorized Official
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Title or Position | PHYSICIAN/PROVIDER
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Name | OTTO MARQUEZ
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Credential | MD PA
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Telephone | 305-431-1376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME122562
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License Number State | FL
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