Provider Demographics
NPI:1215781455
Name:SERRANO, ALEJANDRO
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
Last Name:SERRANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1302
Mailing Address - Street 2:
Mailing Address - City:BAJADERO
Mailing Address - State:PR
Mailing Address - Zip Code:00616-1302
Mailing Address - Country:US
Mailing Address - Phone:939-313-4571
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1302
Practice Address - Street 2:
Practice Address - City:BAJADERO
Practice Address - State:PR
Practice Address - Zip Code:00616-1302
Practice Address - Country:US
Practice Address - Phone:939-313-4571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7467103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical