Provider Demographics
NPI:1508750365
Name:SERRANO LOZADA, MARTA LETICIA
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:LETICIA
Last Name:SERRANO LOZADA
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:PMB 710 20 AVE LUIS MUNOZ MARIN
Mailing Address - Street 2:STE 1 VILLA BLANCA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-385-4861
Mailing Address - Fax:
Practice Address - Street 1:PMB 710 20 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:STE 1 VILLA BLANCA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-385-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8540104100000X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker