MEDICARE: ANA GABRIELA SERRANO LOPEZ MD

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	208D00000X	General Practice Physician	023602	PR

General Provider Information

NPI Number	:	1801562442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA GABRIELA SERRANO LOPEZ MD

Provider Business Mailing Address
First Line	:	AVE LAS AMERICAS #2197
Second Line	:	SUITE #103
City	:	PONCE
State	:	PR
Zip	:	00717-0636
Country	:	US
Telephone Number	:	787-844-3065
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVE LAS AMERICAS #2197
Second Line	:	SUITE #103
City	:	PONCE
State	:	PR
Zip	:	00717-0636
Country	:	US
Telephone Number	:	787-844-3065
Fax Number	:

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

Provider Enumeration Date	:	08/23/2021
Last Update Date	:	12/01/2025

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