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NPI 1821214164

NPI 1821214164 : MARIA M MARQUEZ : LAJAS, PR

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General NPI Number Information
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    NPI Number           |    1821214164
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    Entity Type          |    Individual 
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    Provider Name        |    MARIA M MARQUEZ
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/17/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    CALLE MERCADO # 115 
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    City                 |    LAJAS
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    State                |    PR
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    Zip                  |    00667-9711
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    Country              |    US
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    Telephone            |    787-433-1001
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    BOX 10378 
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    City                 |    LAJAS
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    State                |    PR
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    Zip                  |    00667-9711
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    Country              |    US
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    Telephone            |    787-433-1001
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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        |    247200000X
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    Taxonomy Name        |    Other Technician
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    License Number       |    5271
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    License Number State |    PR
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