Provider Demographics
NPI:1952374506
Name:MARRERO MALDONADO, LUZ NEREIDA (MD)
Entity type:Individual
Prefix:DR
First Name:LUZ
Middle Name:NEREIDA
Last Name:MARRERO MALDONADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 3 K 48
Mailing Address - Street 2:URB VALPARAISO
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-795-9595
Mailing Address - Fax:
Practice Address - Street 1:2 CARR KM 30.4 SUITE 101
Practice Address - Street 2:VEGA ALTA PROFESSIONAL CENTER
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-270-4518
Practice Address - Fax:787-270-4993
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8044207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D32359Medicare UPIN
29711Medicare ID - Type Unspecified