Provider Demographics
NPI:1275357584
Name:DRA. JENNIFER M. SERRANO RIOS LLC
Entity type:Organization
Organization Name:DRA. JENNIFER M. SERRANO RIOS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SERRANO RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-940-1480
Mailing Address - Street 1:361 CALLE TOPACIO
Mailing Address - Street 2:URB. MANSIONES DEL CARIBE
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-940-1480
Mailing Address - Fax:
Practice Address - Street 1:73 EDIFICIO MEDICO SANTA CRUZ
Practice Address - Street 2:CALLE SANTA CRUZ SUITE 303
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00691-6919
Practice Address - Country:US
Practice Address - Phone:787-940-1480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health