MEDICARE: DR. JUAN M MARRERO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	11002	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03655	OTHER	PR	AMERICAN HEALTH PROVIDER
2	4001792	OTHER	PR	CIGNA PROVIDER NUMBER
3	87606	OTHER	PR	TTRIPLESSS PROVIDER NUMBE
4	100968	OTHER	PR	CRUZ AZUL PROVIDER NUMBER

General Provider Information

NPI Number	:	1174528269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN M MARRERO M.D.

Provider Business Mailing Address
First Line	:	267 CALLE INGENIO
Second Line	:	HACIENDA MARGARITA
City	:	LUQUILLO
State	:	PR
Zip	:	00773-3031
Country	:	US
Telephone Number	:	787-314-5854
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVE 3 FONT MARTELO
Second Line	:
City	:	HUMACAO
State	:	PR
Zip	:	00791
Country	:	US
Telephone Number	:	787-852-2424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	02/18/2026

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