Provider Demographics
NPI:1982822813
Name:SERRANO, SHEILA A
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
Last Name:SERRANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 CALLE PRINCIPE ANDRES
Mailing Address - Street 2:ESTANCIAS REALES
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5327
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:133 CALLE PRINCIPE ANDRES
Practice Address - Street 2:ESTANCIAS REALES
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5327
Practice Address - Country:US
Practice Address - Phone:787-287-5127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist