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General NPI Number Information
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NPI Number | 1255123683
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Entity Type | Organization
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Legal Business Name | SERENITY WELLNESS INSTITUTE CORP
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1111 NW 22ND AVE
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City | MIAMI
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State | FL
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Zip | 33125-2738
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Country | US
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Telephone | 305-530-8164
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Fax | 305-530-8987
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Provider Business Mailing Address
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Address Line | 1111 NW 22ND AVE
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City | MIAMI
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State | FL
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Zip | 33125-2738
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Country | US
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Telephone | 305-530-8164
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Fax | 305-530-8987
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Authorized Official
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Title or Position | OWNER
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Name | DIMAS ASENCIO BROTONS
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Credential |
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Telephone | 305-530-8164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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