Healthcare Provider Details

I. General information

NPI: 1679970263
Provider Name (Legal Business Name): MR. HIRIAM MARRERO FIGUEROA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2014
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 149 KM. 12.3
CIALES PR
00638-0000
US

IV. Provider business mailing address

PO BOX 508
CIALES PR
00638-0508
US

V. Phone/Fax

Practice location:
  • Phone: 787-871-0601
  • Fax: 787-871-3960
Mailing address:
  • Phone: 787-871-0601
  • Fax: 787-871-3960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11972
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: