Healthcare Provider Details

I. General information

NPI: 1780252411
Provider Name (Legal Business Name): A SERENE HYDRATION & WELLNESS SPA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2393 S CONGRESS AVE # 211
WEST PALM BEACH FL
33406-7628
US

IV. Provider business mailing address

2393 S CONGRESS AVE # 211
WEST PALM BEACH FL
33406-7628
US

V. Phone/Fax

Practice location:
  • Phone: 561-412-6756
  • Fax:
Mailing address:
  • Phone: 561-412-6756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTINE SENATUS
Title or Position: MANAGER
Credential:
Phone: 561-412-6756