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General NPI Number Information
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NPI Number | 1083774228
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Entity Type | Individual
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Provider Name | CARLOS C MARRERO SR. MD
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CESAR GONZALEZ #463 URB ROOSEVELT
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-274-0277
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Fax | 787-765-2823
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Provider Business Mailing Address
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Address Line | PO BOX 366268
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City | SAN JUAN
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State | PR
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Zip | 00936-6268
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Country | US
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Telephone | 787-274-0277
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Fax | 787-765-2823
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 8381
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License Number State | PR
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