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General NPI Number Information
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NPI Number | 1174528269
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Entity Type | Individual
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Provider Name | JUAN M MARRERO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | AVE 3 FONT MARTELO
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-852-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 267 CALLE INGENIO HACIENDA MARGARITA
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City | LUQUILLO
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State | PR
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Zip | 00773-3031
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Country | US
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Telephone | 787-314-5854
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 11002
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License Number State | PR
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