MEDICARE: DR. CARLA M MARRERO PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5354	PR

General Provider Information

NPI Number	:	1134416803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLA M MARRERO PHARMD

Provider Business Mailing Address
First Line	:	1560 MODENA ST.
Second Line	:	URB. FUENTEBELLA
City	:	TOA ALTA
State	:	PR
Zip	:	00953
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 COLINA YAUREL
Second Line	:	LAS COLINAS
City	:	TOA BAJA
State	:	PR
Zip	:	00949-3239
Country	:	US
Telephone Number	:	787-779-8385
Fax Number	:	787-779-8392

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2011
Last Update Date	:	07/01/2011

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