Provider Demographics
NPI:1477734648
Name:SERRANO CHIROPRACTIC AND WELLNESS LLC
Entity Type:Organization
Organization Name:SERRANO CHIROPRACTIC AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REINALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-356-4571
Mailing Address - Street 1:9040 TOWN CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-4101
Mailing Address - Country:US
Mailing Address - Phone:941-552-5674
Mailing Address - Fax:
Practice Address - Street 1:9040 TOWN CENTER PARKWAY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-4101
Practice Address - Country:US
Practice Address - Phone:941-552-5674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCL125AMedicare UPIN