Provider Demographics
NPI:1497895999
Name:SERRANO-ROSARIO, GLORIMAR (DC)
Entity Type:Individual
Prefix:DR
First Name:GLORIMAR
Middle Name:
Last Name:SERRANO-ROSARIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND MIRAMAR PLZ
Mailing Address - Street 2:15-D
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-3646
Mailing Address - Country:US
Mailing Address - Phone:787-792-2254
Mailing Address - Fax:787-792-1795
Practice Address - Street 1:CONDOMINIO GARDEN CENTER
Practice Address - Street 2:UNIVERSITY GARDENS LOCAL C-5
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-792-2254
Practice Address - Fax:787-792-1795
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor