Provider Demographics
NPI:1215128640
Name:ROMILIO MARQUES MD PA
Entity type:Organization
Organization Name:ROMILIO MARQUES MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMILIO
Authorized Official - Middle Name:F
Authorized Official - Last Name:MARQUES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-774-5437
Mailing Address - Street 1:4330 TAMIAMI TRL E
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-6756
Mailing Address - Country:US
Mailing Address - Phone:239-774-5437
Mailing Address - Fax:239-793-1918
Practice Address - Street 1:4330 TAMIAMI TRL E
Practice Address - Street 2:STE 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-6756
Practice Address - Country:US
Practice Address - Phone:239-774-5437
Practice Address - Fax:239-793-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271589900Medicaid