Provider Demographics
NPI:1780157768
Name:MARRERO GONZALEZ, GREEYTEN TERESA
Entity type:Individual
Prefix:MRS
First Name:GREEYTEN
Middle Name:TERESA
Last Name:MARRERO GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3281 SW 145TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7473
Mailing Address - Country:US
Mailing Address - Phone:786-260-9663
Mailing Address - Fax:
Practice Address - Street 1:664 EAST 25 ST
Practice Address - Street 2:SUITE:101
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013
Practice Address - Country:US
Practice Address - Phone:305-835-7625
Practice Address - Fax:305-835-0550
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11000077363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11000077OtherFAMILY NURSE PRACTITIONER