Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 14487 | PR |
N | 208600000X | Surgeon | 14487 | PR |
Y | 2082S0105X | Plastic Hand Surgeon | 14487 | PR |
NPI | 1952426413 |
---|---|
Provider Name | Dr. Ian Carlos Marrero Amadeo |
First Address | San Juan, PR 00927-6638 |
Second Address | San Juan, PR 00927-6638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 28/02/2013 |