Provider Demographics
NPI:1164090643
Name:MARQUEZ, ALEXIS
Entity type:Individual
Prefix:MR
First Name:ALEXIS
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 QUEEN ALEXANDRIA DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-9108
Mailing Address - Country:US
Mailing Address - Phone:407-716-8943
Mailing Address - Fax:
Practice Address - Street 1:CARROUSEL THERAPY CENTER
Practice Address - Street 2:3201 BUDIGER AVENUE
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769
Practice Address - Country:US
Practice Address - Phone:407-910-2941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health