Healthcare Provider Details

I. General information

NPI: 1740103415
Provider Name (Legal Business Name): CAROLINE ALVES SERBONCHINI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2708 US-19 ALTERNATE SUITE 507-12
PALM HARBOR FL
34683-2662
US

IV. Provider business mailing address

1491 GOPHER LOOP
TARPON SPRINGS FL
34689-5406
US

V. Phone/Fax

Practice location:
  • Phone: 407-808-1049
  • Fax:
Mailing address:
  • Phone: 407-808-1049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-322368
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: