=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326193947
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEJANDRO SERRANO D.C., PHY ASST- C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2007
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4852 JIMMY CARTER BLVD
-----------------------------------------------------
City | NORCROSS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30093-3643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-935-3240
-----------------------------------------------------
Fax | 770-935-3242
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4852 JIMMY CARTER BLVD
-----------------------------------------------------
City | NORCROSS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30093-3643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-934-2222
-----------------------------------------------------
Fax | 770-935-3242
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NX0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Chiropractor
-----------------------------------------------------
License Number | CHIRO 007809
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | 17473
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | 003324
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------