Individual
VICTOR A MAQUERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1895 KINGSLEY AVE, STE 903, ORANGE PARK, FL 32073-4466
(904) 276-1663
(904) 276-2469
Mailing address
PO BOX 17809, JACKSONVILLE, FL 32245-7809
(904) 723-5665
(904) 338-0951
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME59449
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130013419
RAILROAD MEDICARE
FL
01
—
1891786059
NPI
FL
05
—
379665500
—
FL
Enumeration date
11/04/2005
Last updated
01/06/2011
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