Provider Demographics
NPI:1851809891
Name:MARRERO, JOSE RAMON
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:RAMON
Last Name:MARRERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CARRION CT APT 62
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1238
Mailing Address - Country:US
Mailing Address - Phone:787-247-0595
Mailing Address - Fax:
Practice Address - Street 1:16 CARRION CT APT 62
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1238
Practice Address - Country:US
Practice Address - Phone:787-247-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRIKO224343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)