Provider Demographics
NPI:1508327776
Name:SERRA, DAVID (ARNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SERRA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 OCEAN DR APT 15A
Mailing Address - Street 2:
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149-2602
Mailing Address - Country:US
Mailing Address - Phone:786-291-6313
Mailing Address - Fax:
Practice Address - Street 1:881 OCEAN DR APT 15A
Practice Address - Street 2:
Practice Address - City:KEY BISCAYNE
Practice Address - State:FL
Practice Address - Zip Code:33149-2602
Practice Address - Country:US
Practice Address - Phone:786-291-6313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9256948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily