MEDICARE: SIMONA BENEDETTA SERIO

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
1	363L00000X	Nurse Practitioner	95012448	CA

General Provider Information

NPI Number	:	1588254536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONA BENEDETTA SERIO

Provider Business Mailing Address
First Line	:	12660 RIVERSIDE DR STE 310
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-3431
Country	:	US
Telephone Number	:	747-206-9161
Fax Number	:

Provider Business Practice Location Address
First Line	:	12660 RIVERSIDE DR STE 310
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-3431
Country	:	US
Telephone Number	:	747-206-9161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2021
Last Update Date	:	01/30/2023

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Directions to “ SIMONA BENEDETTA SERIO ” Practice Location

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