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General NPI Number Information
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NPI Number | 1649855735
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Entity Type | Organization
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Legal Business Name | SERENDIPITY HEALTH & WELLNESS
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 2662 BLUE CYPRESS LAKE CT
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City | CAPE CORAL
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State | FL
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Zip | 33909-2912
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Country | US
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Telephone | 941-777-4542
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Fax |
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Provider Business Mailing Address
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Address Line | 2662 BLUE CYPRESS LAKE CT
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City | CAPE CORAL
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State | FL
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Zip | 33909-2912
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Country | US
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Telephone | 941-777-4542
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | JENNY BRAGANZA
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Credential |
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Telephone | 714-855-9304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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