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Individual

ILEANA MARQUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1303 HOMESTEAD RD N STE 102, LEHIGH ACRES, FL 33936-6049
(239) 303-2700
(239) 303-2756
Mailing address
1303 HOMESTEAD RD N STE 102, LEHIGH ACRES, FL 33936-6049
(239) 303-2700
(239) 303-2756

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ACN1263
FL
390200000X
Student in an Organized Health Care Education/Training Program
14575I
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ACN1263
FLORIDA ACN MEDICAL LICENSE
FL
Enumeration date
06/22/2018
Last updated
03/07/2023
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