Provider Demographics
NPI:1619180452
Name:MARRERO, ISONIA M (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ISONIA
Middle Name:M
Last Name:MARRERO
Suffix:
Gender:F
Credentials:PHARMACIST
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 29214
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0214
Mailing Address - Country:US
Mailing Address - Phone:787-391-8831
Mailing Address - Fax:787-790-3625
Practice Address - Street 1:47 AVE ESMERALDA
Practice Address - Street 2:URB. MUNOZ RIVERA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4429
Practice Address - Country:US
Practice Address - Phone:787-720-7439
Practice Address - Fax:787-790-3625
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist