Individual provider Active NPI

Sonia I Serrano Serrano, RD

  • Registered Dietitian
  • San Juan, PR
National Provider Identifier
1124150966
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
890 Issued in PR
Practice address
207 Calle Cornell
Apt 402
San Juan, PR 00927-4102
Phone
(787) 758-2525
Fax
(787) 756-8529
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X 890 PR
Registered Dietitian 133V00000X 890 PR Primary

Addresses

Primary practice location

207 Calle Cornell
Apt 402
San Juan, PR 00927-4102

Mailing address

207 Calle Cornell
Apt 402
San Juan, PR 00927-4102
Phone (787) 242-0595

Other identifiers 1

IdentifierTypeStateIssuer
890OtherPRJUNTA DE PROFESIONALES DE LA SALUD DE PR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
890PRMDRenal Nutrition Registered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1124150966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 CALLE CORNELL",
            "address_2": "APT 402",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009274102",
            "telephone_number": "787-242-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 CALLE CORNELL",
            "address_2": "APT 402",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009274102",
            "telephone_number": "787-758-2525",
            "fax_number": "787-756-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO SERRANO",
        "first_name": "SONIA",
        "middle_name": "I",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "PR",
            "license": "890",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PR",
            "license": "890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JUNTA DE PROFESIONALES DE LA SALUD DE PR",
            "identifier": "890",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.