Marivian Pantino Marquez

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30891 Issued in FL

Practice address

1564 Kingsley Ave Ste 200
Orange Park, FL 32073-4521

Phone

(904) 644-8911

Fax

(904) 644-7120

NPI assigned

Jul 16, 2012

Last updated

Oct 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medpro Healthcare Staffing

  • Rehabilitation Hospital
  • Sunrise, FL
  • NPI 1922342021
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1679828685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY",
            "address_2": "SUITE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232859",
            "telephone_number": "954-332-4445",
            "fax_number": "866-422-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1564 KINGSLEY AVE STE 200",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734521",
            "telephone_number": "904-644-8911",
            "fax_number": "904-644-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "MARIVIAN",
        "middle_name": "PANTINO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30891",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0347431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert A. Marino, M.D.
• Mary Elizabeth Markey, MPT
• Markus Sonntag MD
• Marlyn Enterprises of Jacksonville, Inc. (Quality Life Center)
• Monica Marquez Marquez, RBT
• Jessica L Marshall-Ayuso, DO
• Brittany Lee Martens, DNP
• Angela Martin, BCABA
• Darby R Martin, DO
• Gaines Charles Martin, MD

• Physical Therapist in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.