MEDICARE: HEAVENSSERENITY CORP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1134053606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAVENSSERENITY CORP

Provider Business Mailing Address
First Line	:	7321 NW 35TH ST APT 4
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-1654
Country	:	US
Telephone Number	:	352-677-6289
Fax Number	:

Provider Business Practice Location Address
First Line	:	7321 NW 35TH ST APT 4
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-1654
Country	:	US
Telephone Number	:	352-677-6289
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JONATHAN WILLIAMS
Credential	:
Telephone Number	:	352-677-6289

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “HEAVENSSERENITY CORP ” Practice Location

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