Provider Demographics
NPI:1528257599
Name:ELIAS, SERENA (AP, DA, DIPLAC)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:ELIAS
Suffix:
Gender:F
Credentials:AP, DA, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 E COMMERCIAL BLVD
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4216
Mailing Address - Country:US
Mailing Address - Phone:954-489-1144
Mailing Address - Fax:
Practice Address - Street 1:2821 E COMMERCIAL BLVD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4216
Practice Address - Country:US
Practice Address - Phone:954-489-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP0000828171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist