Individual
NIZAR FUAD MARAQA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP PEDIATRIC DEPT., JACKSONVILLE, FL 32209-6511
(904) 244-8345
(904) 244-5341
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME83785
FL
2080P0208X
Pediatric Infectious Diseases Physician
Primary
ME83785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000953279A
—
GA
05
—
2647087-00
—
FL
Enumeration date
03/19/2007
Last updated
06/25/2008
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