Provider Demographics
NPI:1669334223
Name:SERENITY SHORE WELLNESS LLC
Entity type:Organization
Organization Name:SERENITY SHORE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA ALEJANDRA
Authorized Official - Middle Name:ALEJANDRA
Authorized Official - Last Name:ZULUAGA DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-808-0096
Mailing Address - Street 1:3339 HANDY RD APT 211
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4623
Mailing Address - Country:US
Mailing Address - Phone:813-808-0096
Mailing Address - Fax:
Practice Address - Street 1:3339 HANDY RD APT 211
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:818-808-0096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty