Healthcare Provider Details

I. General information

NPI: 1548260276
Provider Name (Legal Business Name): ARACELI RIVERA-SERRANO M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 HOSTOS AVENUE SUITE 205
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

P.O BOX 6468
MAYAGUEZ PR
00681-6468
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-6300
  • Fax: 787-834-6203
Mailing address:
  • Phone: 787-834-6300
  • Fax: 787-834-6203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number8227
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2471N0900X
TaxonomyNuclear Medicine Technology Radiologic Technologist
License Number056
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number8227
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: