=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972979649
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA ANTONIETA SILVA MARQUEZ MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2015
-----------------------------------------------------
Last Update Date | 09/14/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13067 N TELECOM PKWY
-----------------------------------------------------
City | TEMPLE TERRACE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33637-0926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-779-6303
-----------------------------------------------------
Fax | 888-977-1998
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 8569
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34101-8569
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-624-0400
-----------------------------------------------------
Fax | 239-624-0464
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number | ME134332
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------