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NPI Code Detail

MEDICARE: MR. GUSTAVO SERRANO MD

MEDICARE:  MR. GUSTAVO  SERRANO  MD
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
1207RN0300XNephrology PhysicianME0065536FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396732442
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GUSTAVO SERRANO MD
Provider Business Mailing Address
First Line : 5101 N ARMENIA AVE STE A
Second Line :
City : TAMPA
State : FL
Zip : 33603-1405
Country : US
Telephone Number : 813-870-6477
Fax Number : 813-870-6567
Provider Business Practice Location Address
First Line : 5101 N ARMENIA AVE STE A
Second Line :
City : TAMPA
State : FL
Zip : 33603-1405
Country : US
Telephone Number : 813-870-6477
Fax Number : 813-870-6567
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 03/04/2026

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