Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 22437 | PR |
N | 208D00000X | General Practice Physician | ACN1370 | FL |
NPI | 1043894421 |
---|---|
Provider Name | Gilberto Serrano Ocana |
First Address | Orlando, FL 32827-7592 |
Second Address | Orlando, FL 32808-7539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2021 |
Last Update Date | 02/02/2022 |