Provider Demographics
NPI:1255749321
Name:SERRANO, JOHIL M (RPH)
Entity type:Individual
Prefix:
First Name:JOHIL
Middle Name:M
Last Name:SERRANO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2188 AVE. EDUARDO RUBERTE
Mailing Address - Street 2:CARR # 2 SECTOR PAMPANOS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0601
Mailing Address - Country:US
Mailing Address - Phone:787-843-4835
Mailing Address - Fax:787-841-4185
Practice Address - Street 1:2188 AVE. EDUARDO RUBERTE
Practice Address - Street 2:CARR # 2 SECTOR PAMPANOS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0601
Practice Address - Country:US
Practice Address - Phone:787-843-4835
Practice Address - Fax:787-841-4185
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-01
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist