1700100831 NPI number — NIRMA E. SERRANO-NATAL CRNA

Table of content: NIRMA E. SERRANO-NATAL CRNA (NPI 1700100831)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700100831 NPI number — NIRMA E. SERRANO-NATAL CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SERRANO-NATAL
Provider First Name:
NIRMA
Provider Middle Name:
E.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SERRANO
Provider Other First Name:
NIRMA
Provider Other Middle Name:
E.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1700100831
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4918
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32802-4918
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-581-9180
Provider Business Mailing Address Fax Number:
865-560-7066

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 E ROBINSON ST
Provider Second Line Business Practice Location Address:
SUITE #130
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32801-4322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-581-9180
Provider Business Practice Location Address Fax Number:
865-560-7066
Provider Enumeration Date:
03/18/2010

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: 367500000X , with the licence number:  ARNP9315179 , 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: 107124100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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