MEDICARE: ALFONSO SERRANO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	9334	PR

General Provider Information

NPI Number	:	1285630350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFONSO SERRANO MD

Provider Business Mailing Address
First Line	:	EST-GRAN-VISTA # 1 SAN-FRANCISCO
Second Line	:
City	:	GURABO
State	:	PR
Zip	:	00778-5085
Country	:	US
Telephone Number	:	787-736-2224
Fax Number	:

Provider Business Practice Location Address
First Line	:	COLON # 53
Second Line	:
City	:	SAN-LORENZO
State	:	PR
Zip	:	00754
Country	:	US
Telephone Number	:	787-736-2224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	03/19/2012

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