Provider Demographics
NPI:1922007780
Name:SERRANO-MEDINA, RAMON C (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:C
Last Name:SERRANO-MEDINA
Suffix:
Gender:M
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 1159
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1159
Mailing Address - Country:US
Mailing Address - Phone:787-884-2222
Mailing Address - Fax:787-884-2484
Practice Address - Street 1:URB ATENAS
Practice Address - Street 2:MARGINAL ELIOT VELEZ B 44
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-2222
Practice Address - Fax:787-884-2484
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9972207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0087984Medicare PIN