Healthcare Provider Details

I. General information

NPI: 1720159247
Provider Name (Legal Business Name): PEDRO A SERRANO-OJEDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11-25 CARR 174
BAYAMON PR
00959-6609
US

IV. Provider business mailing address

PO BOX 958
BAYAMON PR
00960-0958
US

V. Phone/Fax

Practice location:
  • Phone: 787-993-2800
  • Fax:
Mailing address:
  • Phone: 787-993-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QX0203X
TaxonomyRadiation Oncology Clinic/Center
License Number014754
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code261QX0203X
TaxonomyRadiation Oncology Clinic/Center
License NumberME78916
License Number StateFL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier015098800
Identifier TypeMEDICAID
Identifier StateFL
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: