Provider Demographics
NPI:1821831553
Name:SERENITY PRIMARY CARE LLC
Entity type:Organization
Organization Name:SERENITY PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSECLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARANG
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:772-409-8009
Mailing Address - Street 1:11582 SW VILLAGE PKWY UNIT 283
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2392
Mailing Address - Country:US
Mailing Address - Phone:772-409-8009
Mailing Address - Fax:772-409-8009
Practice Address - Street 1:2399 NW VIA DELLA CT
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4373
Practice Address - Country:US
Practice Address - Phone:772-409-8009
Practice Address - Fax:772-409-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care