Provider Demographics
NPI:1629180351
Name:SERRANO, RICARDO A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:A
Last Name:SERRANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30 FORTENBERRY RD
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952
Mailing Address - Country:US
Mailing Address - Phone:321-453-2267
Mailing Address - Fax:321-453-8019
Practice Address - Street 1:30 FORTENBERRY RD
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-3616
Practice Address - Country:US
Practice Address - Phone:321-453-2267
Practice Address - Fax:321-453-8019
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069902207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine