Provider Demographics
NPI:1245530229
Name:SERRANO GARCIA, IDARMA C (M PSY)
Entity type:Individual
Prefix:MISS
First Name:IDARMA
Middle Name:C
Last Name:SERRANO GARCIA
Suffix:
Gender:F
Credentials:M PSY
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Mailing Address - Street 1:COND JARDINES DEL PARQUE
Mailing Address - Street 2:69 BLVD. MEDIA LUNA APT. 3001
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-4925
Mailing Address - Country:US
Mailing Address - Phone:787-477-4192
Mailing Address - Fax:
Practice Address - Street 1:623 AVE. PONCE DE LEON
Practice Address - Street 2:SUITE 304-B
Practice Address - City:SAN JUAN (HATO REY)
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-750-1472
Practice Address - Fax:787-750-1472
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR3820103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist