Active NPI
Tania I Marrero, PSYD
- Clinical Psychologist
- Saint Cloud, FL
National Provider Identifier
1154668861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY10072
- Practice address
- 4735 Old Canoe Creek Rd
Saint Cloud, FL 34769-1400 - Phone
- (212) 573-9603
- Fax
- (407) 604-7677
- NPI assigned
- Jan 15, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 004740 | PR | |
| Clinical Psychologist | 103TC0700X | PY10072 | FL | Primary |
Addresses
Primary practice location
4735 Old Canoe Creek Rd
Saint Cloud, FL 34769-1400
Mailing address
4735 Old Canoe Creek Rd
Saint Cloud, FL 34769-1400
Phone (321) 257-3960
Other practice location 1
161 Ave Ponce De Leon Ste 206
San Juan, PR 00917-1253
Phone (787) 674-4864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4735 Old Canoe Creek Rd
Saint Cloud, FL 34769-1400
Phone (321) 257-3960
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004740 | PR | MD | Clinical Psychologist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Saint Cloud, FL
- NPI 1982225595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736467200000",
"number": "1154668861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4735 OLD CANOE CREEK RD",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347691400",
"telephone_number": "321-257-3960",
"fax_number": "407-604-7677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4735 OLD CANOE CREEK RD",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347691400",
"telephone_number": "212-573-9603",
"fax_number": "407-604-7677"
}
],
"practiceLocations": [
{
"address_1": "161 Ave Ponce De Leon Ste 206",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "009171253",
"country_code": "US",
"telephone_number": "787-674-4864",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARRERO",
"first_name": "TANIA",
"middle_name": "I",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-15",
"last_updated": "2025-01-10",
"certification_date": "2025-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "004740",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY10072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Cloud, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.