MEDICARE: RACHEL ORTIZ SERRANO PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	0010-05261	NC
2	363A00000X	Physician Assistant	0010-05261	NC

General Provider Information

NPI Number	:	1043613839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ORTIZ SERRANO PA-C

Provider Business Mailing Address
First Line	:	801 YORK ST
Second Line	:
City	:	MANITOWOC
State	:	WI
Zip	:	54220-4630
Country	:	US
Telephone Number	:	920-663-9008
Fax Number	:	920-684-1439

Provider Business Practice Location Address
First Line	:	7560 CARPENTER FIRE STATION RD STE 204
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-9637
Country	:	US
Telephone Number	:	919-439-4206
Fax Number	:	919-439-9375

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2014
Last Update Date	:	07/19/2024

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Directions to “ RACHEL ORTIZ SERRANO PA-C” Practice Location

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