Provider Demographics
NPI:1427676196
Name:MARQUIE AGRONT, PETER (DC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:MARQUIE AGRONT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 FORTENBERRY RD
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-3619
Mailing Address - Country:US
Mailing Address - Phone:321-453-2545
Mailing Address - Fax:321-452-6452
Practice Address - Street 1:230 FORTENBERRY RD
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-3619
Practice Address - Country:US
Practice Address - Phone:321-453-2545
Practice Address - Fax:321-452-6452
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor