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General NPI Number Information
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NPI Number | 1740827500
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Entity Type | Organization
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Legal Business Name | SERINUS MEDCARE PA
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Dates
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Enumeration Date | 11/28/2019
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 648 NE 25TH WAY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3530
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Country | US
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Telephone | 703-470-4112
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Fax |
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Provider Business Mailing Address
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Address Line | 648 NE 25TH WAY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3530
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Country | US
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Telephone | 703-470-4112
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | FERNANDO SALGADO
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Credential |
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Telephone | 703-470-4112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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