Provider Demographics
NPI:1750090304
Name:SERRANO, KEYLA MARIE (MS)
Entity type:Individual
Prefix:
First Name:KEYLA
Middle Name:MARIE
Last Name:SERRANO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 SW CATHEDRAL ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-4539
Mailing Address - Country:US
Mailing Address - Phone:787-510-3710
Mailing Address - Fax:
Practice Address - Street 1:7430 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2130
Practice Address - Country:US
Practice Address - Phone:954-756-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist