Basic Information
| Provider Information | |||||||||
| NPI: | 1417389537 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SERRANO | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | HC 8 BOX 24678 | ||||||||
| Address2: | |||||||||
| City: | AGUADILLA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006039650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875460212 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | HOSPITAL ONCOLOGICO | ||||||||
| Address2: | |||||||||
| City: | RIO PIEDRA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877634149 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2013 | ||||||||
| LastUpdateDate: | 07/31/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 015318-I | PR | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.