Provider Demographics
NPI:1609470632
Name:SERBULESCU, ISABELLE
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:
Last Name:SERBULESCU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20441 NE 30TH AVE APT 222-9
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1548
Mailing Address - Country:US
Mailing Address - Phone:305-333-7329
Mailing Address - Fax:
Practice Address - Street 1:16850 COLLINS AVE STE 101
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4289
Practice Address - Country:US
Practice Address - Phone:305-945-4712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist