Provider Demographics
NPI:1952547846
Name:RODRIGUEZ SERRANO, SERGIO FERNANDO (MD)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:FERNANDO
Last Name:RODRIGUEZ SERRANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:320 PHILLIPS ST STE 201
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-5149
Practice Address - Country:US
Practice Address - Phone:401-295-3120
Practice Address - Fax:401-295-1230
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-23
Last Update Date:2024-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD13404207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine