MEDICARE: SERENDIPITY HEALTH & WELLNESS

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1649855735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENDIPITY HEALTH & WELLNESS

Provider Business Mailing Address
First Line	:	2662 BLUE CYPRESS LAKE CT
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-2912
Country	:	US
Telephone Number	:	941-777-4542
Fax Number	:

Provider Business Practice Location Address
First Line	:	2662 BLUE CYPRESS LAKE CT
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-2912
Country	:	US
Telephone Number	:	941-777-4542
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	JENNY BRAGANZA
Credential	:
Telephone Number	:	714-855-9304

Provider Enumeration Date	:	03/10/2021
Last Update Date	:	03/10/2021

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Directions to “SERENDIPITY HEALTH & WELLNESS ” Practice Location

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