MEDICARE: SERENA ELIAS AP, DA, DIPL.AC.

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	171100000X	Acupuncturist	AP0000828	FL

General Provider Information

NPI Number	:	1528257599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENA ELIAS AP, DA, DIPL.AC.

Provider Business Mailing Address
First Line	:	2821 E COMMERCIAL BLVD
Second Line	:	FIRST FLOOR
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4216
Country	:	US
Telephone Number	:	954-489-1144
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 E COMMERCIAL BLVD
Second Line	:	FIRST FLOOR
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4216
Country	:	US
Telephone Number	:	954-489-1144
Fax Number	:

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

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	10/16/2007

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