MEDICARE: SERENE MEDICAL CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	261Q00000X	Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003663089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENE MEDICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	2900 W CYPRESS CREEK RD STE 8
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1715
Country	:	US
Telephone Number	:	954-437-9070
Fax Number	:

Provider Business Practice Location Address
First Line	:	8080 PASADENA BLVD STE B
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-3537
Country	:	US
Telephone Number	:	954-437-9070
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MRS. MELANIO BRUCETA
Credential	:
Telephone Number	:	954-437-9070

Provider Enumeration Date	:	05/06/2024
Last Update Date	:	11/27/2024

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Directions to “SERENE MEDICAL CENTER, LLC ” Practice Location

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