MEDICARE: YENTL SERRANO

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	225C00000X	Rehabilitation Counselor
2	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1558953794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YENTL SERRANO

Provider Business Mailing Address
First Line	:	1875 VILLAGE CENTER CIR # 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6369
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1875 VILLAGE CENTER CIR # 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6369
Country	:	US
Telephone Number	:	702-529-0699
Fax Number	:

Authorized Official
Title or Position	:	APPLIED CLINICAL NUTRITIONIST
Name	:	YENTL SERRANO
Credential	:
Telephone Number	:	702-529-0699

Provider Enumeration Date	:	02/09/2021
Last Update Date	:	11/25/2025

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Directions to “YENTL SERRANO ” Practice Location

Language	Start Address	Practice Location

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