Provider Demographics
NPI:1215155841
Name:MARIN, NANCY (MD)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:MARIN
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 1:1619 SAN JULIAN ST.
Mailing Address - Street 2:SAGRADO CORAZON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4233
Mailing Address - Country:US
Mailing Address - Phone:787-755-1124
Mailing Address - Fax:
Practice Address - Street 1:1619 SAN JULIAN ST.
Practice Address - Street 2:SAGRADO CORAZON
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4233
Practice Address - Country:US
Practice Address - Phone:787-755-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21456207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine