Provider Demographics
NPI:1871893842
Name:MARQUES, RAFAEL DA COSTA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:DA COSTA
Last Name:MARQUES
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19801 HAMPTON DR STE C3
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2840
Mailing Address - Country:US
Mailing Address - Phone:561-576-3101
Mailing Address - Fax:561-990-1344
Practice Address - Street 1:19801 HAMPTON DR STE C3
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2840
Practice Address - Country:US
Practice Address - Phone:561-576-3101
Practice Address - Fax:561-990-1344
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist