Healthcare Provider Details

I. General information

NPI: 1396879227
Provider Name (Legal Business Name): FRANK RODRIGUEZ SERRANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA SANCHEZ VILELLA ANTIGUO CAMPO RICO GK-33
CAROLINA PR
00983
US

IV. Provider business mailing address

URB TINTILLO GARDENS CALLE 5 H39
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-9198
  • Fax: 787-474-7346
Mailing address:
  • Phone: 939-216-7009
  • Fax: 787-474-7346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number8226
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8226
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: