1366674046 NPI number — DR. SISTO P. SERAFINI D.O.

Table of content: DR. SISTO P. SERAFINI D.O. (NPI 1366674046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366674046 NPI number — DR. SISTO P. SERAFINI D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SERAFINI
Provider First Name:
SISTO
Provider Middle Name:
P.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SERAFINI
Provider Other First Name:
SISTO
Provider Other Middle Name:
P.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1366674046
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8246 RIVER COUNTRY DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING HILL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34607-2101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-684-8637
Provider Business Mailing Address Fax Number:
352-684-8638

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8246 RIVER COUNTRY DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING HILL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34607-2101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-684-8637
Provider Business Practice Location Address Fax Number:
352-684-8638
Provider Enumeration Date:
08/14/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  OS11153 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 591273247 . This is a "MULTIPLAN AND PHCS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 8482165 . This is a "CIGNA PPO/HMO, OPEN ACCESS AND GREATWEST" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 14LS1 . This is a "BCBS BLUE OPTIONS, BLUE CHOICE, FEDERAL, FLORIDA STATE AND TRADITIONAL BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 591273247 . This is a "UHC EMPIRE PLAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 006251800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3996398 . This is a "MAIL HANDLERS BENEFIT PLAN (MHBP)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9963822 . This is a "AETNA, PPO, HMO, EPO, MANAGED CHOICE, MEDICARE HMO/PPO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2447668 . This is a "FIRST HEALTH, GROUP HEALTH AND COVENTRY NATIONAL NETWORK" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3465292 . This is a "UHC COMMERCIAL AND MEDICARE PLANS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 357553 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 14LS1 . This is a "BCBS BLUE CARE, ADVANTAGE 65 SELECT, MEDICARE BCBS PPO/HMO, GO BLUE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 14LS1 . This is a "OUT OF STATE BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 591273247 . This is a "MULTIPLAN, PHCS, PHCS SAVILITY, BEECH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".