Provider Demographics
NPI:1194011064
Name:QUIJANO, ARLENE SERRANO (PA)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:SERRANO
Last Name:QUIJANO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 DUNHILL AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3813
Mailing Address - Country:US
Mailing Address - Phone:954-439-2004
Mailing Address - Fax:
Practice Address - Street 1:450 S ORANGE AVE STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3394
Practice Address - Country:US
Practice Address - Phone:407-930-9551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105639363A00000X
VA0110004640363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical