Healthcare Provider Details

I. General information

NPI: 1457228629
Provider Name (Legal Business Name): SERENA WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14400 NW 77TH CT STE 103
MIAMI LAKES FL
33016-1590
US

IV. Provider business mailing address

5254 NW 94TH DORAL PL
DORAL FL
33178-2017
US

V. Phone/Fax

Practice location:
  • Phone: 949-994-6708
  • Fax: 949-994-6550
Mailing address:
  • Phone: 949-994-6708
  • Fax: 949-994-6550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA SIERVO
Title or Position: OWNER
Credential:
Phone: 949-994-6708