Provider Demographics
NPI:1093998320
Name:MARRERO, RICARDO JUAN (MD)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:JUAN
Last Name:MARRERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 COLLINS AVE
Mailing Address - Street 2:APARTMENT 2905
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4627
Mailing Address - Country:US
Mailing Address - Phone:305-807-4494
Mailing Address - Fax:
Practice Address - Street 1:6301 COLLINS AVE
Practice Address - Street 2:APARTMENT 2905
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-4627
Practice Address - Country:US
Practice Address - Phone:305-807-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16988207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology