Healthcare Provider Details

I. General information

NPI: 1255767430
Provider Name (Legal Business Name): ANA YANIRA GARCIA MARRERO M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 CALLE 4 JARDINES DE TOA ALTA
TOA ALTA PR
00953-1807
US

IV. Provider business mailing address

46 CALLE 4 JARDINES DE TOA ALTA
TOA ALTA PR
00953-1807
US

V. Phone/Fax

Practice location:
  • Phone: 787-870-2529
  • Fax:
Mailing address:
  • Phone: 787-870-2529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number020550
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number020550
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: