Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO2973 | FL |
NPI | 1154628063 |
---|---|
Provider Name | Dr. Nydia Serrano |
First Address | Orlando, FL 32822-7669 |
Second Address | Orlando, FL 32822-7669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2011 |
Last Update Date | 12/02/2011 |