Provider Demographics
NPI:1720573181
Name:JOSE LUIS SERRANO MONTES, MD, CSP
Entity Type:Organization
Organization Name:JOSE LUIS SERRANO MONTES, MD, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARIA
Authorized Official - Prefix:
Authorized Official - First Name:NORELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-202-8277
Mailing Address - Street 1:HC 645 BOX 5300
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-9705
Mailing Address - Country:US
Mailing Address - Phone:939-202-8277
Mailing Address - Fax:
Practice Address - Street 1:LOTE E A1 CARR 181
Practice Address - Street 2:REPARTO TRAPICHE
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-9705
Practice Address - Country:US
Practice Address - Phone:939-202-8277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care