Healthcare Provider Details

I. General information

NPI: 1811759442
Provider Name (Legal Business Name): JUAN ESTEBAN SERRANO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 S OCEAN DR APT 19B
HALLANDALE BEACH FL
33009-5932
US

IV. Provider business mailing address

1985 S OCEAN DR APT 19B
HALLANDALE BEACH FL
33009-5932
US

V. Phone/Fax

Practice location:
  • Phone: 786-742-5239
  • Fax:
Mailing address:
  • Phone: 786-742-5239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: