Healthcare Provider Details

I. General information

NPI: 1821919267
Provider Name (Legal Business Name): ANUMIS MARIE SERRANO GUTIERREZ PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 1 BOX 7671
HATILLO PR
00659-7347
US

IV. Provider business mailing address

HC 1 BOX 7671
HATILLO PR
00659-7347
US

V. Phone/Fax

Practice location:
  • Phone: 787-449-0768
  • Fax:
Mailing address:
  • Phone: 787-449-0768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001906
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: