Healthcare Provider Details

I. General information

NPI: 1912822750
Provider Name (Legal Business Name): LEANDRA KRYSTAL SERRANO RUIZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR #2 KM 86.6 MARGINAL DE ATLANTIC TOYOTA
HATILLO PR
00659
US

IV. Provider business mailing address

345 BLVD MEDIA LUNA
CAROLINA PR
00987-5159
US

V. Phone/Fax

Practice location:
  • Phone: 787-680-5444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8588
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: