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NPI Code Detail

MEDICARE: LISA MARIE SERRA CFOM

MEDICARE: LISA MARIE SERRA CFOM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Z00000XOrthotist

General Provider Information

NPI Number : 1366397762
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE SERRA CFOM
Provider Business Mailing Address
First Line : 1481 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2803
Country : US
Telephone Number : 317-988-3230
Fax Number :
Provider Business Practice Location Address
First Line : 1481 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2803
Country : US
Telephone Number : 317-988-3230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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Directions to “ LISA MARIE SERRA CFOM” Practice Location

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