Provider Demographics
NPI:1285126615
Name:MARRERO, CHRISTINE CARIDAD (DO)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CARIDAD
Last Name:MARRERO
Suffix:
Gender:F
Credentials:DO
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 198054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8054
Mailing Address - Country:US
Mailing Address - Phone:786-595-9900
Mailing Address - Fax:
Practice Address - Street 1:8400 NW 53RD ST # 104
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-4511
Practice Address - Country:US
Practice Address - Phone:786-595-9900
Practice Address - Fax:786-533-9475
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS17113207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine