Provider Demographics
NPI:1194619460
Name:AMADOR MARRERO, ADRIAN (APRN)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:AMADOR MARRERO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1087
Mailing Address - Country:US
Mailing Address - Phone:305-325-5511
Mailing Address - Fax:305-325-5511
Practice Address - Street 1:1400 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1087
Practice Address - Country:US
Practice Address - Phone:305-325-5511
Practice Address - Fax:305-325-5511
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038137363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care