Healthcare Provider Details

I. General information

NPI: 1487801262
Provider Name (Legal Business Name): SERENDITYPATTI ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2008
Last Update Date: 08/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8124 ENGLISH ELM CIR
SPRING HILL FL
34606-6705
US

IV. Provider business mailing address

8124 ENGLISH ELM CIR
SPRING HILL FL
34606-6705
US

V. Phone/Fax

Practice location:
  • Phone: 813-659-2502
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2425
License Number StateFL

VIII. Authorized Official

Name: BRIAN CLUKIE
Title or Position: ADMINISTRATOR
Credential:
Phone: 813-659-2502