Provider Demographics
NPI:1780027599
Name:SERDYUK, INNA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:INNA
Middle Name:
Last Name:SERDYUK
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 1:231 174TH ST
Mailing Address - Street 2:APARTMENT 2302
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3368
Mailing Address - Country:US
Mailing Address - Phone:786-202-7263
Mailing Address - Fax:
Practice Address - Street 1:17100 COLLINS AVE
Practice Address - Street 2:SUITE 216
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3675
Practice Address - Country:US
Practice Address - Phone:305-945-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107118363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical