Provider Demographics
NPI:1558795336
Name:RAMIRO MARRERO M.D.P.A.
Entity Type:Organization
Organization Name:RAMIRO MARRERO M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRERO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:786-253-5375
Mailing Address - Street 1:4160 W 16TH AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5853
Mailing Address - Country:US
Mailing Address - Phone:785-253-5375
Mailing Address - Fax:305-661-8796
Practice Address - Street 1:4160 W 16TH AVE
Practice Address - Street 2:SUITE 504
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5853
Practice Address - Country:US
Practice Address - Phone:785-253-5375
Practice Address - Fax:305-661-8796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050272300Medicaid
91077OtherMEDICARE PART A
FL91077OtherMEDICARE PAR B