MEDICARE: ROXANA GORDON MARQUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-22-209210	FL
2	111NR0400X	Rehabilitation Chiropractor	22-209210	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003522988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXANA GORDON MARQUEZ

Provider Business Mailing Address
First Line	:	1118 FONTANA ST E
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33974-4531
Country	:	US
Telephone Number	:	786-909-0492
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 LORELEI AVE
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-5928
Country	:	US
Telephone Number	:	786-909-0492
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	03/23/2026

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Directions to “ ROXANA GORDON MARQUEZ ” Practice Location

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