Provider Demographics
NPI:1497089767
Name:SERRANO PORRATA, MILDRED LIVETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:MILDRED
Middle Name:LIVETTE
Last Name:SERRANO PORRATA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:40 CALLE PROTESTANTE
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-2952
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 123 KM 9.8
Practice Address - Street 2:CENTRO COMERCIAL LAS DELICIAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-0000
Practice Address - Country:US
Practice Address - Phone:787-607-8576
Practice Address - Fax:787-841-4326
Is Sole Proprietor?:No
Enumeration Date:2009-09-19
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17731208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice