Healthcare Provider Details

I. General information

NPI: 1538025549
Provider Name (Legal Business Name): PATRICIA MERCEDES SERRANO LOPEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2197 BLVD LUIS A FERRE SUITE #103
PONCE PR
00717-0636
US

IV. Provider business mailing address

P.O.BOX 1427
PONCE PR
00733
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-3065
  • Fax:
Mailing address:
  • Phone: 787-667-5959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number3588
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: