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General NPI Number Information
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NPI Number | 1558183020
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Entity Type | Organization
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Legal Business Name | SERENITY MEDICAL AESTHETICS LLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 4665 DOUGLAS CIR NW STE 103
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City | CANTON
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State | OH
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Zip | 44718-3673
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Country | US
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Telephone | 330-354-3885
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Fax |
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Provider Business Mailing Address
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Address Line | 4665 DOUGLAS CIR NW STE 103
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City | CANTON
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State | OH
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Zip | 44718-3673
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL RIVERA-WEISS
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Credential | MD
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Telephone | 330-354-3885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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