Healthcare Provider Details

I. General information

NPI: 1700659828
Provider Name (Legal Business Name): ANA LUISA SERRANO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 NW 36TH ST
MIAMI SPRINGS FL
33166-5923
US

IV. Provider business mailing address

5209 NW 36TH ST
MIAMI SPRINGS FL
33166-5923
US

V. Phone/Fax

Practice location:
  • Phone: 786-712-7752
  • Fax:
Mailing address:
  • Phone: 786-712-7752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: