1992787048 NPI number — MS. CARMEN MILAGROS MARRERO MD

Table of content: MS. CARMEN MILAGROS MARRERO MD (NPI 1992787048)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992787048 NPI number — MS. CARMEN MILAGROS MARRERO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARRERO
Provider First Name:
CARMEN
Provider Middle Name:
MILAGROS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARRERO
Provider Other First Name:
CARMEN
Provider Other Middle Name:
MILAGROS
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1992787048
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
488 CARR 845
Provider Second Line Business Mailing Address:
URB PURPLE TREE
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-4403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-761-1945
Provider Business Mailing Address Fax Number:
787-761-1947

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
488 CARR 845
Provider Second Line Business Practice Location Address:
URB PURPLE TREE
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926-4403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-761-1945
Provider Business Practice Location Address Fax Number:
787-761-1947
Provider Enumeration Date:
11/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  9548 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QG0300X , with the licence number: 9548 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 069435 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "PALIC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 81953 . This is a "TRIPLE S (SSS)" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "COSVI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "SALUD DORADO CON MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 81953 . This is a "MEDICARE OPTIMO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 20085 . This is a "PREFERRED HEALTH (UTI)" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "MAPFRE L." identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "OPTION HEALTH CARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "MEDICAL CARD SYSTEM (MCS)" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "MCS CLASSICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "FIRST PLUS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9280057 . This is a "HUMANA HEALTH PLANS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 500168E . This is a "MEDICARE Y MUCHO MAS (MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660563176 . This is a "AUXILIO PLATINO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9280057 . This is a "HUMANA INSURANCE OF PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 2758 . This is a "PREFERRED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4214 . This is a "INTERNATIONAL MEDICAL CAR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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