Provider Demographics
NPI:1720106669
Name:MARRERO, RAYSA ACOSTA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYSA
Middle Name:ACOSTA
Last Name:MARRERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 SW 139TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-6640
Mailing Address - Country:US
Mailing Address - Phone:305-773-8787
Mailing Address - Fax:305-232-2907
Practice Address - Street 1:JSCH 9333 SW 152ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1778
Practice Address - Country:US
Practice Address - Phone:305-256-5001
Practice Address - Fax:305-256-5003
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0075940207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine