Provider Demographics
NPI:1730386848
Name:MARRERO, DORIS A
Entity type:Individual
Prefix:MISS
First Name:DORIS
Middle Name:A
Last Name:MARRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 582
Mailing Address - Street 2:BO CIENAGA SECTOR PALOMAR
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-0582
Mailing Address - Country:US
Mailing Address - Phone:787-638-9559
Mailing Address - Fax:
Practice Address - Street 1:1400 CALLE SAN RAFAEL
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909-2693
Practice Address - Country:US
Practice Address - Phone:787-638-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1004171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor