Healthcare Provider Details

I. General information

NPI: 1780563197
Provider Name (Legal Business Name): SERENITY NEUROCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 SW 122ND AVE APT 5C
MIAMI FL
33175-7352
US

IV. Provider business mailing address

1950 SW 122ND AVE APT 5C
MIAMI FL
33175-7352
US

V. Phone/Fax

Practice location:
  • Phone: 786-608-4395
  • Fax:
Mailing address:
  • Phone: 786-608-4395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DAYANA RODRIGUEZ
Title or Position: OWNER
Credential: PSY.D.
Phone: 866-084-3957