Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | ME61674 | FL |
NPI | 1497810949 |
---|---|
Provider Name | Dr. Jorge L Serrat |
First Address | Pembroke Pines, FL 33029-2825 |
Second Address | Pembroke Pines, FL 33029-2825 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 04/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F46754 | (02) | MD |