Healthcare Provider Details

I. General information

NPI: 1639531957
Provider Name (Legal Business Name): RICARDO JOSE MARRERO-TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR 21 INT 18 BARRIO MONACILLOS
SAN JUAN PR
00927-3027
US

IV. Provider business mailing address

URB LOS ARBOLES DE MONTEHIEDRA 440 BLVD DE LOS ARBOLES
SAN JUAN PR
00926-7160
US

V. Phone/Fax

Practice location:
  • Phone: 787-936-1477
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number01089218A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number19886
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19886
License Number StatePR
# 4
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDR.0072186
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: