Provider Demographics
NPI:1477533032
Name:MARINO, INGRID MILAGROS (MD)
Entity Type:Individual
Prefix:DR
First Name:INGRID
Middle Name:MILAGROS
Last Name:MARINO
Suffix:
Gender:F
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:PO BOX 1573
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-1573
Mailing Address - Country:US
Mailing Address - Phone:787-529-3059
Mailing Address - Fax:
Practice Address - Street 1:JJ31 CALLE MIRAMAR
Practice Address - Street 2:DORADO DEL MAR
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-529-3059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR57832080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine