Individual provider Active NPI

Lourdes Serrano Molina, MS, CCCSLP

  • Speech-Language Pathologist
  • Isabela, PR
National Provider Identifier
1275935926
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
196 Issued in PR
Practice address
133 Calle Dr Gonzalez
Isabela, PR 00662-2633
Phone
(787) 872-5565
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 196 PR Primary

Addresses

Primary practice location

133 Calle Dr Gonzalez
Isabela, PR 00662-2633

Mailing address

PO Box 23
Bajadero, PR 00616-0023
Phone (787) 632-6296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191007000033 PR Practitioner - Qualified Speech Language Pathologist 1052642071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
196PRMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Adultos Y Ninos Con Impedimentos Inc CurrentSince Jun 21, 2019 Accepting new patients

Locations

133 Calle Dr Gonzalez
Isabela, PR 00662
Phone (787) 872-5565

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1275935926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "BAJADERO",
            "state": "PR",
            "postal_code": "006160023",
            "telephone_number": "787-632-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 CALLE DR GONZALEZ",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006622633",
            "telephone_number": "787-872-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO MOLINA",
        "first_name": "LOURDES",
        "credential": "MS, CCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Isabela, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.