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NPI Code Detail

MEDICARE: ADRIAN M MARQUEZ AYALA L.M.H.C.

MEDICARE: ADRIAN M MARQUEZ AYALA L.M.H.C.
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
1101YM0800XMental Health Counselor
2101YM0800XMental Health Counselor17648FL

General Provider Information

NPI Number : 1457869034
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIAN M MARQUEZ AYALA L.M.H.C.
Provider Business Mailing Address
First Line : 6767 N WICKHAM RD STE 400W
Second Line :
City : MELBOURNE
State : FL
Zip : 32940-2025
Country : US
Telephone Number : 321-345-0638
Fax Number : 508-901-2991
Provider Business Practice Location Address
First Line : 6767 N WICKHAM RD STE 400W
Second Line :
City : MELBOURNE
State : FL
Zip : 32940-2025
Country : US
Telephone Number : 321-345-0638
Fax Number : 508-901-2991
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2018
Last Update Date : 03/02/2026

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