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NPI Code Detail

MEDICARE: JORGE L SERRA MD

MEDICARE:   JORGE L SERRA  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
1207R00000XInternal Medicine PhysicianME0058799FL

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 : 1841287208
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE L SERRA MD
Provider Business Mailing Address
First Line : 3501 HEALTH CENTER BLVD
Second Line : SUITE 2190
City : FORT MYERS
State : FL
Zip : 33908
Country : US
Telephone Number : 239-221-8475
Fax Number : 239-221-8487
Provider Business Practice Location Address
First Line : 3501 HEALTH CENTER BLVD
Second Line : SUITE 2190
City : FORT MYERS
State : FL
Zip : 33908
Country : US
Telephone Number : 239-221-8475
Fax Number : 239-221-8487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 12/07/2009

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