Provider Demographics
NPI:1497810949
Name:SERRAT, JORGE L (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:L
Last Name:SERRAT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:650 NW 180TH TER
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2825
Mailing Address - Country:US
Mailing Address - Phone:954-392-1880
Mailing Address - Fax:954-392-1088
Practice Address - Street 1:650 NW 180TH TER
Practice Address - Street 2:SUITE 101
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2825
Practice Address - Country:US
Practice Address - Phone:954-392-1880
Practice Address - Fax:954-392-1088
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2015-06-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME616742080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF46754Medicare UPIN