Provider Demographics
NPI:1407017015
Name:SERENA SARA CHIROPRACTIC CENTER PLLC
Entity Type:Organization
Organization Name:SERENA SARA CHIROPRACTIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SERENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-431-2713
Mailing Address - Street 1:13301 SW 83RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-6607
Mailing Address - Country:US
Mailing Address - Phone:305-431-2713
Mailing Address - Fax:
Practice Address - Street 1:10531 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3758
Practice Address - Country:US
Practice Address - Phone:305-431-2713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERENA SARA CHIROPRACTIC CENTER PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-17
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty