Provider Demographics
NPI:1326217274
Name:SERMAC MEDICAL & PSYCH CARE, INC.
Entity Type:Organization
Organization Name:SERMAC MEDICAL & PSYCH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./BUSINESS OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:
Authorized Official - Last Name:THYS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-863-7800
Mailing Address - Street 1:5730 CORPORATE WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2032
Mailing Address - Country:US
Mailing Address - Phone:561-863-7800
Mailing Address - Fax:561-840-0747
Practice Address - Street 1:5730 CORPORATE WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2032
Practice Address - Country:US
Practice Address - Phone:561-863-7800
Practice Address - Fax:561-840-0747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0059794174400000X
FLME-00597942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1750391371OtherPROVIDER-NPI
FL376590300Medicaid
FL1750391371OtherPROVIDER-NPI
FLE86367Medicare UPIN