Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 103G00000X | Clinical Psychologist | 6913 | PR |
Y | 103TC0700X | Clinical Psychologist | 6913 | PR |
NPI | 1013472257 |
---|---|
Provider Name | Dr. Daniel Serrano Gonzalez |
First Address | Arecibo, PR 00612-6823 |
Second Address | Barceloneta, PR 00617-3240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2019 |
Last Update Date | 28/08/2021 |