Provider Demographics
NPI:1164649844
Name:ROBERT, MARIANITA
Entity Type:Individual
Prefix:MRS
First Name:MARIANITA
Middle Name:
Last Name:ROBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:D8 CALLE DE LA VERA
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7357
Mailing Address - Country:US
Mailing Address - Phone:278-728-8825
Mailing Address - Fax:787-786-8234
Practice Address - Street 1:AVE. AGUAS BUENAS BLOQ.16 # 34
Practice Address - Street 2:SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-995-0861
Practice Address - Fax:787-995-0861
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography