Provider Demographics
NPI:1942539028
Name:SERRANO-ALVIRA, MAYDA NADIR (DC)
Entity Type:Individual
Prefix:DR
First Name:MAYDA
Middle Name:NADIR
Last Name:SERRANO-ALVIRA
Suffix:
Gender:F
Credentials:DC
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 136
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0136
Mailing Address - Country:US
Mailing Address - Phone:787-246-6452
Mailing Address - Fax:787-280-1335
Practice Address - Street 1:120 CALLE PAVIA FERNANDEZ
Practice Address - Street 2:STE. 249
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2285
Practice Address - Country:US
Practice Address - Phone:787-246-6452
Practice Address - Fax:787-280-1335
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-18
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR473111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor