Provider Demographics
NPI:1275718819
Name:MARRERO, KAMIR I (PSYD)
Entity Type:Individual
Prefix:
First Name:KAMIR
Middle Name:I
Last Name:MARRERO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 E. JACKSON ST.
Mailing Address - Street 2:ADVANCED PSYCHIATRIC GROUP, P.A.
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801
Mailing Address - Country:US
Mailing Address - Phone:407-423-7149
Mailing Address - Fax:407-422-0470
Practice Address - Street 1:417 E. JACKSON ST.
Practice Address - Street 2:ADVANCED PSYCHIATRIC GROUP, P.A.
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801
Practice Address - Country:US
Practice Address - Phone:407-423-7149
Practice Address - Fax:407-422-0470
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7638103TC0700X
FLPY0002026103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical