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General NPI Number Information
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NPI Number | 1952547846
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Entity Type | Individual
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Provider Name | SERGIO FERNANDO RODRIGUEZ SERRANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | CNEMG PRIMARY CARE OF COVENTRY-BROOKSIDE 595 WASHINGTON STREET
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City | COVENTRY
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State | RI
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Zip | 02816
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Country | US
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Telephone | 401-822-2772
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Fax | 401-821-5260
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Provider Business Mailing Address
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Address Line | 455 TOLL GATE RD PRC AND CREDENTIALING
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City | WARWICK
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State | RI
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Zip | 02886-2759
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Country | US
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Telephone | 401-273-0641
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Fax | 401-273-2919
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD13404
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License Number State | RI
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