Provider Demographics
NPI:1013559863
Name:FERRIS, SERENA (PA)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:FERRIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SERENA
Other - Middle Name:MARIE
Other - Last Name:PEREZ-FERRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1952 FIELD RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-2316
Mailing Address - Country:US
Mailing Address - Phone:941-926-7546
Mailing Address - Fax:941-926-8811
Practice Address - Street 1:1952 FIELD RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-2316
Practice Address - Country:US
Practice Address - Phone:941-926-7546
Practice Address - Fax:941-926-8811
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant