Provider Demographics
NPI:1861584609
Name:FUCHS, MARQUITA M (NP)
Entity type:Individual
Prefix:
First Name:MARQUITA
Middle Name:M
Last Name:FUCHS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5700 CANOGA AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6579
Mailing Address - Country:US
Mailing Address - Phone:818-595-8100
Mailing Address - Fax:818-595-8206
Practice Address - Street 1:1958 DAIRY RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-4045
Practice Address - Country:US
Practice Address - Phone:800-530-5441
Practice Address - Fax:818-595-8206
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP1304032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS04637Medicare UPIN