Provider Demographics
NPI:1699367557
Name:SERRANO, ALEX JOHN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:JOHN
Last Name:SERRANO
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 CEDAR FALLS DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1727
Mailing Address - Country:US
Mailing Address - Phone:786-202-7979
Mailing Address - Fax:
Practice Address - Street 1:7901 SW 6TH CT STE 110
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3248
Practice Address - Country:US
Practice Address - Phone:954-368-9841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily