Healthcare Provider Details

I. General information

NPI: 1053059907
Provider Name (Legal Business Name): ZUJEILY SERRANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17162 OLD CHENEY HWY
ORLANDO FL
32833-2788
US

IV. Provider business mailing address

PO BOX 158
APOPKA FL
32704-0158
US

V. Phone/Fax

Practice location:
  • Phone: 407-883-3072
  • Fax:
Mailing address:
  • Phone: 407-883-3072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: