Provider Demographics
NPI:1992491435
Name:SERRANO, YAIRISIS M. RIVERA
Entity type:Individual
Prefix:
First Name:YAIRISIS M.
Middle Name:RIVERA
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:URB LEVITTOWN LAKES
Mailing Address - Street 2:FE15 CALLE RAMON MARIN
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-2722
Mailing Address - Country:US
Mailing Address - Phone:939-219-6106
Mailing Address - Fax:
Practice Address - Street 1:PASEO LOS VETERANOS 1010
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:939-219-6106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program