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General NPI Number Information
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NPI Number | 1275002602
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Entity Type | Individual
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Provider Name | MEREDITH JOCELYN SEROTA
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Gender | Female
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 1001 W CYPRESS CREEK RD STE 120
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-1947
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Country | US
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Telephone | 855-832-6727
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Fax |
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Provider Business Mailing Address
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Address Line | 934 SW 21ST WAY
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City | BOCA RATON
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State | FL
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Zip | 33486-5238
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Country | US
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Telephone | 561-757-0691
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-18-68921
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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