1881268704 NPI number — MISS YAJAIRA M SERRANO ROSARIO MSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881268704 NPI number — MISS YAJAIRA M SERRANO ROSARIO MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSARIO
Provider First Name:
YAJAIRA M
Provider Middle Name:
SERRANO
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881268704
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
COND. BEVERLY HILLS COURT
Provider Second Line Business Mailing Address:
100 CARMEN HILLS DRIVE APT 142
Provider Business Mailing Address City Name:
SAN JUAN PR
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-283-9999
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL ONCOLOGICO
Provider Second Line Business Practice Location Address:
CALLE 5 CASA K18
Provider Business Practice Location Address City Name:
BO MONACILLOS CENTRO MEDICO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-763-4149
Provider Business Practice Location Address Fax Number:
787-999-4514
Provider Enumeration Date:
05/15/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  11871 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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