Provider Demographics
NPI:1356235733
Name:MINGIA, SERINA MAXINE
Entity type:Individual
Prefix:
First Name:SERINA
Middle Name:MAXINE
Last Name:MINGIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 INTERNATIONAL PKWY LAKE MARY, FL 32746
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746
Mailing Address - Country:US
Mailing Address - Phone:727-377-4315
Mailing Address - Fax:
Practice Address - Street 1:12725 RACE TRACK RD
Practice Address - Street 2:
Practice Address - City:WESTCHASE
Practice Address - State:FL
Practice Address - Zip Code:33626-1314
Practice Address - Country:US
Practice Address - Phone:813-467-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician