Marliz Medical LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MARLIZ MEDICAL LLC

Practice address

Ave. Agustin Ramos Calero
#7260
Isobela, PR 00662

Phone

(787) 872-8313

Fax

(787) 872-0352

NPI assigned

Oct 13, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Marco A Corchado Barreto Sr., M.D.NPI 1750376406

Title

President

Phone

(787) 872-8313

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marco Antonio Corchado Barreto, M.D.

  • Adult Medicine Physician
  • Isabela, PR
  • NPI 1750376406

  Family Medicine, PR

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634860800000",
    "number": "1700548120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1039",
            "city": "ISOBELA",
            "state": "PR",
            "postal_code": "00662",
            "telephone_number": "787-872-8313",
            "fax_number": "787-872-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. AGUSTIN RAMOS CALERO",
            "address_2": "#7260",
            "city": "ISOBELA",
            "state": "PR",
            "postal_code": "00662",
            "telephone_number": "787-872-8313",
            "fax_number": "787-872-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLIZ MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "CORCHADO BARRETO",
        "authorized_official_first_name": "MARCO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-872-8313",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.