Provider Demographics
NPI:1578622957
Name:SERRANO, LUIS M (PA)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:M
Last Name:SERRANO
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:13400 SW 120 STREET
Mailing Address - Street 2:# 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185
Mailing Address - Country:US
Mailing Address - Phone:305-278-5951
Mailing Address - Fax:305-278-5971
Practice Address - Street 1:13400 SW 120TH ST
Practice Address - Street 2:# 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7440
Practice Address - Country:US
Practice Address - Phone:305-278-5951
Practice Address - Fax:305-278-5971
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2015-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9102147363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical