Provider Demographics
NPI:1932786118
Name:SHAFFREN, SERENA BETH (MD)
Entity type:Individual
Prefix:DR
First Name:SERENA
Middle Name:BETH
Last Name:SHAFFREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SERENA
Other - Middle Name:BETH
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:601 4TH ST S # 4013
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:727-553-1295
Practice Address - Street 1:501 6TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4634
Practice Address - Country:US
Practice Address - Phone:727-828-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME168338208000000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics