MEDICARE: DR. DENISE SERAFIN M.D.

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	208000000X	Pediatrics Physician	ME94123	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME 94123	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1356321657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE SERAFIN M.D.

Provider Business Mailing Address
First Line	:	2101 PARK CENTER DR
Second Line	:	SUITE 130
City	:	ORLANDO
State	:	FL
Zip	:	32835-7626
Country	:	US
Telephone Number	:	407-297-0080
Fax Number	:	407-292-4912

Provider Business Practice Location Address
First Line	:	2101 PARK CENTER DR
Second Line	:	SUITE 130
City	:	ORLANDO
State	:	FL
Zip	:	32835-7626
Country	:	US
Telephone Number	:	407-297-0080
Fax Number	:	407-292-4912

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	07/08/2007

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