Provider Demographics
NPI:1639510738
Name:SERRI, LIMOR (PA-C)
Entity Type:Individual
Prefix:
First Name:LIMOR
Middle Name:
Last Name:SERRI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 GALT OCEAN DR
Mailing Address - Street 2:SUITE 1615
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-6542
Mailing Address - Country:US
Mailing Address - Phone:561-750-5495
Mailing Address - Fax:
Practice Address - Street 1:307 VIA DE PALMAS
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6007
Practice Address - Country:US
Practice Address - Phone:561-750-5495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant