Provider Demographics
NPI:1003186420
Name:SERRANO PAGAN, JENNIFER (PHARM D)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SERRANO PAGAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 12471
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-7341
Mailing Address - Country:US
Mailing Address - Phone:787-509-2081
Mailing Address - Fax:
Practice Address - Street 1:505 AVE HOSTOS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1797
Practice Address - Country:US
Practice Address - Phone:787-831-0674
Practice Address - Fax:787-834-2698
Is Sole Proprietor?:No
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist