Provider Demographics
NPI:1649271008
Name:MARRERO, JEANNETTE (MD)
Entity type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:202 CALLE JULIO CINTRON
Mailing Address - Street 2:SUITE 220 BOX. 152
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-3312
Mailing Address - Country:US
Mailing Address - Phone:787-735-0377
Mailing Address - Fax:787-735-0377
Practice Address - Street 1:202 CALLE JULIO CINTRON
Practice Address - Street 2:SUITE 220 BOX. 152
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3312
Practice Address - Country:US
Practice Address - Phone:787-735-0377
Practice Address - Fax:787-735-0377
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR103412080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8-3144MAOtherSSS
PRM-000326OtherPLAN MENONITA