Provider Demographics
NPI:1205373859
Name:SERRADET, MIGUEL (ARNP)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:
Last Name:SERRADET
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14920 SW 63RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2751
Mailing Address - Country:US
Mailing Address - Phone:786-712-2733
Mailing Address - Fax:
Practice Address - Street 1:2695 LEUNE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-446-0330
Practice Address - Fax:305-445-3267
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9274031363LF0000X
FLRBT-20-135565106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily