Provider Demographics
NPI:1881601326
Name:SERRANO DECOS, MAYRALIZ (AUD)
Entity type:Individual
Prefix:DR
First Name:MAYRALIZ
Middle Name:
Last Name:SERRANO DECOS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LA MARINA 4 R 54 FIDELA CRUZ ST.
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7544
Mailing Address - Country:US
Mailing Address - Phone:787-755-0707
Mailing Address - Fax:787-755-0707
Practice Address - Street 1:1712 CALLE PARANA
Practice Address - Street 2:URB EL CEREZAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3148
Practice Address - Country:US
Practice Address - Phone:787-755-0707
Practice Address - Fax:787-755-0707
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR570231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist