Provider Demographics
NPI:1235724378
Name:MARRERO ENDOCRINOLOGY AND METABOLISM LLC
Entity Type:Organization
Organization Name:MARRERO ENDOCRINOLOGY AND METABOLISM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DEL CARMEN
Authorized Official - Last Name:MARRERO MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-376-6384
Mailing Address - Street 1:PO BOX 141591
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1591
Mailing Address - Country:US
Mailing Address - Phone:787-568-3573
Mailing Address - Fax:
Practice Address - Street 1:11 CALLE ANA LENS DE SUSONI
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-568-3573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2022-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR19896OtherLICENSE