Provider Demographics
NPI:1316295330
Name:SERAPHIN, VARDAH (ARNP)
Entity type:Individual
Prefix:
First Name:VARDAH
Middle Name:
Last Name:SERAPHIN
Suffix:
Gender:F
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:PO BOX 530985
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33153-0985
Mailing Address - Country:US
Mailing Address - Phone:786-317-7159
Mailing Address - Fax:
Practice Address - Street 1:551 NW 110TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-3246
Practice Address - Country:US
Practice Address - Phone:786-317-7159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-23
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9282374363L00000X
302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN9282374OtherBOARD OF NURSING