Healthcare Provider Details

I. General information

NPI: 1689980294
Provider Name (Legal Business Name): JOHANNA D'AGOSTINO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOHANNA SERRANO M.D.

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 SE 5TH AVE
DELRAY BEACH FL
33483-5213
US

IV. Provider business mailing address

526 SE 5TH AVE
DELRAY BEACH FL
33483-5213
US

V. Phone/Fax

Practice location:
  • Phone: 561-330-9500
  • Fax:
Mailing address:
  • Phone: 561-330-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number287419
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberME139671
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: