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General NPI Number Information
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NPI Number | 1003663089
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Entity Type | Organization
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Legal Business Name | SERENE MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 05/06/2024
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 8080 PASADENA BLVD STE B
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3537
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Country | US
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Telephone | 954-437-9070
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 W CYPRESS CREEK RD STE 8
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-1715
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Country | US
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Telephone | 954-437-9070
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. MELANIO BRUCETA
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Credential |
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Telephone | 954-437-9070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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