Provider Demographics
NPI:1861010191
Name:MOLINA-SERRANO, MONICA (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:MOLINA-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:PO BOX 8773
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-8773
Mailing Address - Country:US
Mailing Address - Phone:939-204-6426
Mailing Address - Fax:
Practice Address - Street 1:342 CALLE SAN LUIS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-1623
Practice Address - Country:US
Practice Address - Phone:787-705-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21864208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice