# MR. VICTOR MEDINA SERALDE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1255449047
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME0041355 | FL | Yes |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 01/10/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 067369200 | MEDICAID INDIVIDUAL PROVIDER VICTOR SERALDE | FL |
| 01 | — | 259715200 | MEDIPASS PROVIDER NUMBER GROUP | FL |
| 01 | — | 28115 | MEDICARE INDIVIDUAL PROVIDER DR. VICTOR SERALDE | FL |
| 01 | — | 28115A | MEDICARE PROVIDER NUMBER OF VICTOR SERALDE IN FAIRMOUNT CLINIC | FL |
| 01 | — | 41214C | MEDICARE PROVIDER NUMBER CIRILO SERALDE IN FAIRMOUNT CLINIC | FL |
| 01 | — | K2401 | MEDICARE PART B GROUP PROVIDER NUMBER | FL |