Provider Demographics
NPI:1477387330
Name:MARRERO, JAHAZIEL (MSN- ARNP-PMHNP)
Entity type:Individual
Prefix:
First Name:JAHAZIEL
Middle Name:
Last Name:MARRERO
Suffix:
Gender:M
Credentials:MSN- ARNP-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 SW 95TH TER APT 202
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4608
Mailing Address - Country:US
Mailing Address - Phone:305-609-9745
Mailing Address - Fax:
Practice Address - Street 1:211 SW 95TH TER APT 202
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-4608
Practice Address - Country:US
Practice Address - Phone:305-609-9745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-31
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035028363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health