Provider Demographics
NPI:1427773985
Name:SERRANO, ISHBEL PAOLA
Entity type:Individual
Prefix:
First Name:ISHBEL
Middle Name:PAOLA
Last Name:SERRANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2599 EAGLE BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-6093
Mailing Address - Country:US
Mailing Address - Phone:689-252-0234
Mailing Address - Fax:
Practice Address - Street 1:4 COND SAN FERNANDO VLG APT 226
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-6959
Practice Address - Country:US
Practice Address - Phone:689-252-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9498240163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy