Provider Demographics
NPI:1861541914
Name:MENDEZ SERRANO, CARLOS E (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:MENDEZ SERRANO
Suffix:
Gender:M
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:HC-02 BOX 19505
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-9721
Mailing Address - Country:US
Mailing Address - Phone:787-507-7751
Mailing Address - Fax:787-200-8498
Practice Address - Street 1:LUIS MUNOZ MARIN AVE.
Practice Address - Street 2:PISO G, HIMA SAN PABLO CAGUAS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726-5429
Practice Address - Country:US
Practice Address - Phone:787-744-8686
Practice Address - Fax:787-258-1125
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17775207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology