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General NPI Number Information
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NPI Number | 1629623350
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Entity Type | Individual
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Provider Name | OMAR GAMALIER SERRANO
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Gender | Male
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 08/08/2019
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Provider Practice Location Address
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Address Line | 1706 E SEMORAN BLVD STE 107
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City | APOPKA
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State | FL
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Zip | 32703-5610
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Country | US
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Telephone | 407-880-7772
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Fax |
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Provider Business Mailing Address
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Address Line | 1233 SEBURN RD
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City | APOPKA
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State | FL
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Zip | 32703-8466
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Country | US
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Telephone | 479-923-4904
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT34995
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License Number State | FL
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