Provider Demographics
NPI:1578778247
Name:SERRANO-AYALA, GILBERTO (BSW)
Entity Type:Individual
Prefix:MR
First Name:GILBERTO
Middle Name:
Last Name:SERRANO-AYALA
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 COND FLORIMAR
Mailing Address - Street 2:APT D303
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5238
Mailing Address - Country:US
Mailing Address - Phone:787-760-0819
Mailing Address - Fax:
Practice Address - Street 1:4 COND FLORIMAR
Practice Address - Street 2:APT D303
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5238
Practice Address - Country:US
Practice Address - Phone:787-760-0819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4681104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker