Provider Demographics
NPI:1104330760
Name:SERRET, JORGE (ARNP)
Entity type:Individual
Prefix:MR
First Name:JORGE
Middle Name:
Last Name:SERRET
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 W FLAGLER ST APT 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3916
Mailing Address - Country:US
Mailing Address - Phone:786-683-4944
Mailing Address - Fax:
Practice Address - Street 1:315 W 9TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3853
Practice Address - Country:US
Practice Address - Phone:786-360-4528
Practice Address - Fax:786-360-4529
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-18
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9290001363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty