MEDICARE: SERDJINE APPLYRS

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1639047780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERDJINE APPLYRS

Provider Business Mailing Address
First Line	:	2208 EVANS ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-1202
Country	:	US
Telephone Number	:	754-204-4097
Fax Number	:

Provider Business Practice Location Address
First Line	:	2208 EVANS ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-1202
Country	:	US
Telephone Number	:	754-204-4097
Fax Number	:

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

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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Directions to “ SERDJINE APPLYRS ” Practice Location

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