Provider Demographics
NPI:1467034355
Name:SERRANO, DANIEL ALEXCANDER (FNP-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALEXCANDER
Last Name:SERRANO
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-6006
Mailing Address - Country:US
Mailing Address - Phone:321-841-3467
Mailing Address - Fax:321-843-3386
Practice Address - Street 1:2906 17TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-6006
Practice Address - Country:US
Practice Address - Phone:321-841-3467
Practice Address - Fax:321-841-3386
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012795363LF0000X
FLAPRN11012795363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily