Provider Demographics
NPI:1750879888
Name:SERRANO ROSADO, YAN SR (MSW)
Entity type:Individual
Prefix:PROF
First Name:YAN
Middle Name:
Last Name:SERRANO ROSADO
Suffix:SR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CALLE BARNES
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-3120
Mailing Address - Country:US
Mailing Address - Phone:787-455-7608
Mailing Address - Fax:
Practice Address - Street 1:53 CALLE 25 DE JULIO
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1705
Practice Address - Country:US
Practice Address - Phone:787-455-7608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR138671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical