Provider Demographics
NPI:1285630376
Name:BORRERO-SERRANO, RUBEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:
Last Name:BORRERO-SERRANO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 BROOKMYRA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5103
Mailing Address - Country:US
Mailing Address - Phone:407-856-0208
Mailing Address - Fax:
Practice Address - Street 1:4250 TOWN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6192
Practice Address - Country:US
Practice Address - Phone:407-856-0208
Practice Address - Fax:407-856-8113
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8411223G0001X
FLDN122721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice