Provider Demographics
NPI:1295931772
Name:ZARRILLO, IVETTE MARGARITA (MD)
Entity type:Individual
Prefix:
First Name:IVETTE
Middle Name:MARGARITA
Last Name:ZARRILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IVETTE
Other - Middle Name:MARGARITA
Other - Last Name:LAMBOY MEDINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1484 STRAITS DR STE 5
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-8718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1484 STRAITS DR STE 5
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-8718
Practice Address - Country:US
Practice Address - Phone:989-667-8740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11990208D00000X
MI4301108932208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice