Provider Demographics
NPI:1639441629
Name:SERRANO, ERIKA P
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:P
Last Name:SERRANO
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 1:2508 CENTERGATE DR
Mailing Address - Street 2:APT 203
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7241
Mailing Address - Country:US
Mailing Address - Phone:954-608-5278
Mailing Address - Fax:
Practice Address - Street 1:10794 PINES BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3920
Practice Address - Country:US
Practice Address - Phone:954-735-3535
Practice Address - Fax:954-484-7000
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA43164225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist