| Serenity Integrated Medical Group Psc | |
|
1123 Ave Hostos Ponce PR 00717-0952 | |
| (787) 377-1277 | |
| Not Available |
| Full Name | Serenity Integrated Medical Group Psc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1123 Ave Hostos, Ponce, Puerto Rico |
| Authorized Official Name and Position | Jaime Luis Rodriguez (PRESIDENT) |
| Authorized Official Contact | 7872955554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Integrated Medical Group Psc Estancias Del Monte 13 Calle Guilarte Coto Laurel PR 00780 Ph: (787) 377-1277 | Serenity Integrated Medical Group Psc 1123 Ave Hostos Ponce PR 00717-0952 Ph: (787) 377-1277 |
| NPI Number | 1538945969 |
|---|---|
| Provider Enumeration Date | 09/01/2023 |
| Last Update Date | 09/01/2023 |
| Certification Date | 08/30/2023 |
| Medicare PECOS PAC ID | 4981052321 |
|---|---|
| Medicare Enrollment ID | O20231127001237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538945969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jaime Luis Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982852489 PECOS PAC ID: 9830355387 Enrollment ID: I20120727000103 |
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