MEDICARE: BENJAMIN P MARQUEZ MD PA

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	207Q00000X	Family Medicine Physician	ME0070788	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	31492	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508905407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENJAMIN P MARQUEZ MD PA

Provider Business Mailing Address
First Line	:	953 DEL WEBB BLVD EAST
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-6669
Country	:	US
Telephone Number	:	813-634-6880
Fax Number	:	813-634-6833

Provider Business Practice Location Address
First Line	:	953 DEL WEBB BLVD EAST
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-6669
Country	:	US
Telephone Number	:	813-634-6880
Fax Number	:	813-634-6833

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BENJAMIN PANGLAO MARQUEZ
Credential	:	M.D.
Telephone Number	:	813-634-6880

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	03/11/2010

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