Provider Demographics
NPI:1255635736
Name:MARRERO, MAHE (PHARMD)
Entity type:Individual
Prefix:
First Name:MAHE
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7295 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1401
Mailing Address - Country:US
Mailing Address - Phone:305-262-6682
Mailing Address - Fax:305-264-4318
Practice Address - Street 1:950 1ST ST S STE 103
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3607
Practice Address - Country:US
Practice Address - Phone:305-262-6682
Practice Address - Fax:305-264-4318
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS45244OtherSTATE LICENSE