Provider Demographics
NPI:1295933117
Name:MARRERO, CAMIL I (MD)
Entity type:Individual
Prefix:DR
First Name:CAMIL
Middle Name:I
Last Name:MARRERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAMIL
Other - Middle Name:I
Other - Last Name:MARRERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:140 SW 84TH AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2736
Mailing Address - Country:US
Mailing Address - Phone:954-452-5850
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:140 SW 84TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2736
Practice Address - Country:US
Practice Address - Phone:954-452-5850
Practice Address - Fax:954-851-1746
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11391I207V00000X
PR26416 R207V00000X
FLME110771207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology