Healthcare Provider Details

I. General information

NPI: 1912740010
Provider Name (Legal Business Name): DR MARRERO MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB COLINAS DE LUQUILLO CALLE 4 #74
LUQUILLO PR
00773
US

IV. Provider business mailing address

PO BOX 814
LUQUILLO PR
00773-0814
US

V. Phone/Fax

Practice location:
  • Phone: 787-955-9181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: EFRAIN MARRERO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-955-9181