Healthcare Provider Details

I. General information

NPI: 1174738876
Provider Name (Legal Business Name): HECTOR SERRA-GARCIA BA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CALLE CERRA PDA. 15 CDT GUALBERTO RABELL
SAN JUAN PR
00907-5104
US

IV. Provider business mailing address

1668 CALLE SANTA LUISA ALTAMESA
SAN JUAN PR
00921-4321
US

V. Phone/Fax

Practice location:
  • Phone: 787-721-3220
  • Fax: 787-721-3207
Mailing address:
  • Phone: 787-774-8502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: