Provider Demographics
NPI:1093354557
Name:MARRERO-SERRA, CATHYRIA MARIELA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CATHYRIA
Middle Name:MARIELA
Last Name:MARRERO-SERRA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CATHYRIA
Other - Middle Name:MARIELA
Other - Last Name:MARRERO-SERRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 80220
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-8220
Mailing Address - Country:US
Mailing Address - Phone:787-206-9827
Mailing Address - Fax:
Practice Address - Street 1:282 AVE JESUS T PINERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-3921
Practice Address - Country:US
Practice Address - Phone:787-523-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6718183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6718OtherSTATE LICENSE