Provider Demographics
NPI:1003105982
Name:SERRANO, JEANNETTE (MT)
Entity Type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:
Last Name:SERRANO
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0726
Mailing Address - Country:US
Mailing Address - Phone:787-412-2297
Mailing Address - Fax:
Practice Address - Street 1:ROAD 446 KM 3.5 BARRIO ROBLES
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-412-2297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory