Provider Demographics
NPI:1790273142
Name:SERRANO, OLGA IRIS (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:IRIS
Last Name:SERRANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SANTO TOMAS AQUINO
Mailing Address - Street 2:C68 LOS DOMINICOS
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957
Mailing Address - Country:US
Mailing Address - Phone:939-308-3378
Mailing Address - Fax:
Practice Address - Street 1:SANTO TOMAS AQUINO
Practice Address - Street 2:C68 LOS DOMINICOS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:939-308-3378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21408208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice