Provider Demographics
NPI:1619537230
Name:SERENITY SOLUTIONS INC
Entity Type:Organization
Organization Name:SERENITY SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LMT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BOWES
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:772-985-6754
Mailing Address - Street 1:1705 19TH PL STE H3
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-0687
Mailing Address - Country:US
Mailing Address - Phone:772-985-6754
Mailing Address - Fax:
Practice Address - Street 1:1705 19TH PL STE H3
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-0687
Practice Address - Country:US
Practice Address - Phone:772-985-6754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMM33051OtherSTATE ESTABLISHMENT NUMBER MM33051