Individual provider Active NPI

Marjorie I Quevedo, RDCS, RVT, RDMS

  • Sonography Radiologic Technologist
  • Orlando, FL
National Provider Identifier
1770739039
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Radiologic TechnologistTaxonomy code 2471S1302X
License
118715 Issued in FL
Practice address
70 W Gore St
Ste 202
Orlando, FL 32806-1124
Phone
(407) 788-0455
Fax
(407) 389-0931
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sonography Radiologic Technologist 2471S1302X 118715 FL Primary

Addresses

Primary practice location

70 W Gore St
Ste 202
Orlando, FL 32806-1124

Mailing address

70 W Gore St
Ste 202
Orlando, FL 32806-1124
Phone (407) 788-0455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
118715FLMDSonography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1770739039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 W GORE ST",
            "address_2": "STE 202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061124",
            "telephone_number": "407-788-0455",
            "fax_number": "407-389-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 W GORE ST",
            "address_2": "STE 202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061124",
            "telephone_number": "407-788-0455",
            "fax_number": "407-389-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEVEDO",
        "first_name": "MARJORIE",
        "middle_name": "I",
        "credential": "RDCS, RVT, RDMS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "FL",
            "license": "118715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.