Provider Demographics
NPI:1306437850
Name:SERRANO, ENRIQUE (APRN)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:SERRANO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 SW 27TH AVE APT 107
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2138
Mailing Address - Country:US
Mailing Address - Phone:305-282-7070
Mailing Address - Fax:
Practice Address - Street 1:2575 SW 27TH AVE APT 107
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2138
Practice Address - Country:US
Practice Address - Phone:305-282-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010880363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care