Healthcare Provider Details

I. General information

NPI: 1598890022
Provider Name (Legal Business Name): ZAIRA SERRANO GARCIA PHYSICALL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIF. LAS VEGAS #420, BO CAMPO ALEGRE
MANATI PR
00674-1086
US

IV. Provider business mailing address

PO BOX 1086 EDIF. LAS VEGAS #420, BO CAMPO ALEGRE
MANATI PR
00674-1086
US

V. Phone/Fax

Practice location:
  • Phone: 787-854-1426
  • Fax: 787-884-3757
Mailing address:
  • Phone: 787-854-1426
  • Fax: 787-884-3757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1283
License Number StatePR

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: