Provider Demographics
NPI:1487775649
Name:SERRANO, ENRIQUE ANGEL (MD)
Entity type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:ANGEL
Last Name:SERRANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W OAK ST STE 370
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4910
Mailing Address - Country:US
Mailing Address - Phone:407-483-3376
Mailing Address - Fax:305-642-3344
Practice Address - Street 1:720 W OAK ST STE 370
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4910
Practice Address - Country:US
Practice Address - Phone:407-483-3376
Practice Address - Fax:305-642-3344
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0545092084N0400X
FL1030802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME103080OtherMEDICAL LICENSE