Provider Demographics
NPI:1427927763
Name:SERENITY MENTAL HEALTH GROUP LLC
Entity type:Organization
Organization Name:SERENITY MENTAL HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENRRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MEDINILLA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:831-325-5539
Mailing Address - Street 1:13101 NW 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-1406
Mailing Address - Country:US
Mailing Address - Phone:831-325-5539
Mailing Address - Fax:
Practice Address - Street 1:13101 NW 19TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-1406
Practice Address - Country:US
Practice Address - Phone:831-325-5539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty