Provider Demographics
NPI:1073606752
Name:PEREZ MARRERO, MARIA C (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:C
Last Name:PEREZ MARRERO
Suffix:
Gender:F
Credentials:MD
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 443
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681
Mailing Address - Country:US
Mailing Address - Phone:787-849-6055
Mailing Address - Fax:787-849-6055
Practice Address - Street 1:CALLE MATEO FAJARDO 8
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-849-6055
Practice Address - Fax:787-849-6055
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6610208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR100152WOtherMEDICARE Y MUCHO MAS
PR1651OtherPREFERRED MEDICARE CHOICE
PRC77588Medicare UPIN
PR100152WOtherMEDICARE Y MUCHO MAS