Provider Demographics
NPI:1336963677
Name:MARRERO-CARRASQUILLO, JESSY ANETTE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESSY
Middle Name:ANETTE
Last Name:MARRERO-CARRASQUILLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. PRADERAS DE NAVARRO
Mailing Address - Street 2:477 CALLE OJO DE TIGRE
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-9044
Mailing Address - Country:US
Mailing Address - Phone:787-484-7826
Mailing Address - Fax:
Practice Address - Street 1:URB. PRADERAS DE NAVARRO
Practice Address - Street 2:477 CALLE OJO DE TIGRE
Practice Address - City:00778
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-484-7826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist