Provider Demographics
NPI:1760580567
Name:MARRERO ORTIZ, OSCAR (MD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:MARRERO ORTIZ
Suffix:
Gender:M
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:POBOX 1619
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:RI
Mailing Address - Zip Code:00783
Mailing Address - Country:US
Mailing Address - Phone:787-568-1234
Mailing Address - Fax:787-268-7271
Practice Address - Street 1:716 C/COCATIER MONTEBELLO
Practice Address - Street 2:LOS MONTES
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-568-1234
Practice Address - Fax:787-268-7271
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16017208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice