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General NPI Number Information
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NPI Number | 1104932961
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Entity Type | Individual
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Provider Name | JOSE ANTONIO SERRANO ROBLES M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | DE DIEGO 486, ALTOS
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City | SAN JUAN
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State | PR
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Zip | 00923
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Country | US
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Telephone | 787-767-8707
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Fax |
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Provider Business Mailing Address
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Address Line | K9 TOLIMA PARK GARDENS
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City | SAN JUAN
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State | PR
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Zip | 00926-2146
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Country | US
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Telephone | 787-761-5877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 5265
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License Number State | PR
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