Provider Demographics
NPI:1215164926
Name:MARRERO, CARMEN MARIA (DO)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:MARIA
Last Name:MARRERO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:561-293-2900
Mailing Address - Fax:561-412-5554
Practice Address - Street 1:4998 10TH AVE N
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-2210
Practice Address - Country:US
Practice Address - Phone:561-293-2900
Practice Address - Fax:561-412-5554
Is Sole Proprietor?:No
Enumeration Date:2009-06-20
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 10657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine