Provider Demographics
NPI:1902136948
Name:MARRERO, WANDA I (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:WANDA
Middle Name:I
Last Name:MARRERO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MERIDA 717
Mailing Address - Street 2:VILLAS DEL SOL
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:
Practice Address - Street 1:PRACTICA FARMACIA RECINTO CIENCIA MEDICA AREA CENT MED
Practice Address - Street 2:DECANATO DE ESTUDIANTES Y FARMACIA PISO 3 OFICINA 327
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR37071835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist