Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 6170 | PR |
NPI | 1043266265 |
---|---|
Provider Name | Dr. Jaime Marques Marques |
First Address | San Juan, PR 00926-5302 |
Second Address | San Juan, PR 00926-5330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 12/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C82083 | (02) | PR |