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General NPI Number Information
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NPI Number | 1376387688
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Entity Type | Individual
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Provider Name | MAXIMILIAN ERIC MIHEL SRNA
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Gender | Male
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 3360 BURNS RD
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4323
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Country | US
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Telephone | 561-622-1411
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Fax |
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Provider Business Mailing Address
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Address Line | 7343 CORTES LAKE DR
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City | DELRAY BEACH
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State | FL
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Zip | 33446-5605
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Country | US
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Telephone | 561-305-7210
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9513032
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License Number State | FL
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