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General NPI Number Information
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NPI Number | 1265600399
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Entity Type | Individual
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Provider Name | MARLENE MICHELLE PIERANTONI M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 06/23/2011
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Provider Practice Location Address
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Address Line | 21 CASIA STREET VA CARIBBEAN HEALTHCARE SYSTEM
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City | SAN JUAN
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-642-7581
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Fax |
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Provider Business Mailing Address
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Address Line | 21 CASIA STREET VA CARIBBEAN HEALTHCARE SYSTEM
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City | SAN JUAN
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-642-7581
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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 | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | ME 100358
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME100358
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 17591
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License Number State | PR
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