Provider Demographics
NPI:1407275324
Name:SERRANO, LUIS FELIPE (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:FELIPE
Last Name:SERRANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W OAK ST STE 150
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4990
Mailing Address - Country:US
Mailing Address - Phone:773-328-0079
Mailing Address - Fax:
Practice Address - Street 1:720 W OAK ST STE 150
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4990
Practice Address - Country:US
Practice Address - Phone:407-338-4010
Practice Address - Fax:407-338-4801
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME139335208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program