Provider Demographics
NPI:1326621236
Name:MARQUEZ, ANDREA C (MD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:C
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 1ST AVE N UNIT 2801
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3750
Mailing Address - Country:US
Mailing Address - Phone:754-281-8295
Mailing Address - Fax:
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-734-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2024-07-30
Deactivation Date:2022-04-11
Deactivation Code:
Reactivation Date:2022-05-09
Provider Licenses
StateLicense IDTaxonomies
FLME166780207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine