Provider Demographics
NPI:1285856013
Name:SERRANO, JOCELYN PATRICIA TAN (MD)
Entity Type:Individual
Prefix:
First Name:JOCELYN PATRICIA
Middle Name:TAN
Last Name:SERRANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOCELYN PATRICIA
Other - Middle Name:DE GRACIA
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13575 HEATHCOTE BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-6698
Mailing Address - Country:US
Mailing Address - Phone:571-248-4620
Mailing Address - Fax:571-248-4374
Practice Address - Street 1:13575 HEATHCOTE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-6698
Practice Address - Country:US
Practice Address - Phone:571-248-4620
Practice Address - Fax:571-248-4374
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine