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General NPI Number Information
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NPI Number | 1750879888
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Entity Type | Individual
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Provider Name | YAN SERRANO ROSADO SR. MSW
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Gender | Male
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 53 CALLE 25 DE JULIO
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City | SABANA GRANDE
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State | PR
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Zip | 00637-1705
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Country | US
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Telephone | 787-455-7608
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Fax |
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Provider Business Mailing Address
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Address Line | 8 CALLE BARNES
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City | PONCE
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State | PR
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Zip | 00730-3120
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Country | US
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Telephone | 787-455-7608
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13867
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License Number State | PR
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