Provider Demographics
NPI:1386625705
Name:DRA CARMEN M MARRERO PSC
Entity type:Organization
Organization Name:DRA CARMEN M MARRERO PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:MILAGROS
Authorized Official - Last Name:MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-761-1943
Mailing Address - Street 1:488 CARR 845
Mailing Address - Street 2:URB PURPLE TREE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4403
Mailing Address - Country:US
Mailing Address - Phone:787-761-1943
Mailing Address - Fax:787-761-1947
Practice Address - Street 1:488 CARR 845
Practice Address - Street 2:URB PURPLE TREE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4403
Practice Address - Country:US
Practice Address - Phone:787-761-1943
Practice Address - Fax:787-761-1947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20085OtherPREFERRED HEALTH UTI
PR4214OtherINTL MEDICAL CARD
PR9280057OtherHUMANA INSURANCE OF PR
PR1386625705OtherMCS CLASSICARE
PR1386625705OtherHUMANA MEDICARE
PR81953OtherMEDICARE OPTIMO
PR1386625705OtherMCS
PR1386625705OtherPALIC
PR2758OtherPREFERRED MEDICARE CHOICE
PR9280057OtherHUMANA HEALTH PLANS
PR069435OtherCRUZ AZUL
PR1386625705OtherMAPFRE
PR1386625705OtherOPTION HEALTH CARE
PR500168EOtherMEDICARE Y MUCHO MAS
PR81953OtherTRIPLE S
PR81953OtherMEDICARE OPTIMO
PR1386625705OtherMAPFRE
PR0082775Medicare PIN