Provider Demographics
NPI:1699203380
Name:SERRANO, KAREN VANESSA
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:VANESSA
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 1:3989 ATRIUM DR # 3989
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3738
Mailing Address - Country:US
Mailing Address - Phone:321-333-6289
Mailing Address - Fax:
Practice Address - Street 1:3524 SAXONY LN
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-8600
Practice Address - Country:US
Practice Address - Phone:407-994-5361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician