Healthcare Provider Details

I. General information

NPI: 1497552400
Provider Name (Legal Business Name): SERENE SLEEP OF FLORIDA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 CITRUS TOWER BLVD STE 101
CLERMONT FL
34711-6113
US

IV. Provider business mailing address

425 CITRUS TOWER BLVD STE 101
CLERMONT FL
34711-6113
US

V. Phone/Fax

Practice location:
  • Phone: 352-243-9930
  • Fax:
Mailing address:
  • Phone: 352-243-9930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. SETH CALISH
Title or Position: MANAGER
Credential: DMD, MS
Phone: 407-949-7324