Provider Demographics
NPI:1720256381
Name:SERRANO, LUIS FERNANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:FERNANDO
Last Name:SERRANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2569 JARDIN WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1521
Mailing Address - Country:US
Mailing Address - Phone:954-774-2096
Mailing Address - Fax:
Practice Address - Street 1:1380 NE MIAMI GARDENS DR DEPT OF
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-4707
Practice Address - Country:US
Practice Address - Phone:305-994-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2572402085R0202X
FLME1445782085R0202X
LAMD2018382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology