Healthcare Provider Details

I. General information

NPI: 1194011064
Provider Name (Legal Business Name): ARLENE SERRANO QUIJANO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 S ORANGE AVE
ORLANDO FL
32801-3383
US

IV. Provider business mailing address

2421 DUNHILL AVE
MIRAMAR FL
33025-3813
US

V. Phone/Fax

Practice location:
  • Phone: 407-305-8322
  • Fax: 407-264-8686
Mailing address:
  • Phone: 954-439-2004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9105639
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110004640
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: