Provider Demographics
NPI:1427693662
Name:MARQUEZ, KARINA (PT, DPT)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N ROME AVE APT 4325
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-0052
Mailing Address - Country:US
Mailing Address - Phone:817-995-3357
Mailing Address - Fax:
Practice Address - Street 1:1750 N 50TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-3104
Practice Address - Country:US
Practice Address - Phone:813-247-4489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT35347225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT35347OtherPHYSICAL THERAPY LICENSE