Provider Demographics
NPI:1548260276
Name:RIVERA-SERRANO, ARACELI (MD)
Entity type:Individual
Prefix:MRS
First Name:ARACELI
Middle Name:
Last Name:RIVERA-SERRANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 6468
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6468
Mailing Address - Country:US
Mailing Address - Phone:787-834-6300
Mailing Address - Fax:787-834-6203
Practice Address - Street 1:351 HOSTOS AVENUE SUITE 205
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-6300
Practice Address - Fax:787-834-6203
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8227170100000X, 207U00000X
PR0562471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
No2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine Technology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR17235OtherAMPR
PR91440003OtherHUMANA
PR38227OtherCIGNA
PR660451404OtherFSE
PR0581OtherIMC
PR067418OtherCA
PR3003639OtherACAA
PR890270OtherMMM
PR38227OtherCIGNA
PR17235OtherAMPR