Healthcare Provider Details

I. General information

NPI: 1275492993
Provider Name (Legal Business Name): JULIA SERNA AGUDELO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 GLADES RD STE 400
BOCA RATON FL
33431-6469
US

IV. Provider business mailing address

11300 NE 2ND AVE
MIAMI FL
33161-6628
US

V. Phone/Fax

Practice location:
  • Phone: 561-750-2100
  • Fax: 561-750-0889
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: