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NPI Code Detail

MEDICARE: DR. IAN CARLOS MARRERO AMADEO MD

MEDICARE:  DR. IAN CARLOS MARRERO AMADEO  MD
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
1208200000XPlastic Surgery Physician14487PR
22082S0105XSurgery of the Hand (Plastic Surgery) Physician14487PR

General Provider Information

NPI Number : 1952426413
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IAN CARLOS MARRERO AMADEO MD
Provider Business Mailing Address
First Line : 310 AVE LOMAS VERDES
Second Line : SUITE 202
City : SAN JUAN
State : PR
Zip : 00927-6638
Country : US
Telephone Number : 787-272-5000
Fax Number : 787-272-5010
Provider Business Practice Location Address
First Line : 310 AVE LOMAS VERDES
Second Line : SUITE 202
City : SAN JUAN
State : PR
Zip : 00927-6638
Country : US
Telephone Number : 787-272-5000
Fax Number : 787-272-5010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 02/28/2013

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