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

Table of content: ROSELYN M RIVERA MSW (NPI 1578021424)

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".




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