MEDICARE: MATTHEW MARRERO RESPETO MD

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	390200000X	Student in an Organized Health Care Education/Training Program		AZ

General Provider Information

NPI Number	:	1649103755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW MARRERO RESPETO MD

Provider Business Mailing Address
First Line	:	17222 N CENTRAL AVE APT 126
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-2336
Country	:	US
Telephone Number	:	937-992-1623
Fax Number	:

Provider Business Practice Location Address
First Line	:	17222 N CENTRAL AVE APT 126
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-2336
Country	:	US
Telephone Number	:	937-992-1623
Fax Number	:

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

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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