Provider Demographics
NPI:1942870217
Name:SERRANO, YOSMEL (RN)
Entity Type:Individual
Prefix:
First Name:YOSMEL
Middle Name:
Last Name:SERRANO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 FULLER ST NW APT 205
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-5609
Mailing Address - Country:US
Mailing Address - Phone:305-331-1145
Mailing Address - Fax:
Practice Address - Street 1:8665 BURTON WAY APT 314
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3993
Practice Address - Country:US
Practice Address - Phone:305-331-1145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-09-26
Deactivation Date:2023-01-10
Deactivation Code:
Reactivation Date:2023-01-25
Provider Licenses
StateLicense IDTaxonomies
DCRN1052505163W00000X
CA95001938367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse