# RICARDO A SERRANO MD LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922280619
- **Authorized official:** RICARDO A SERRANO MD (OWNER & MD)
- **Authorized official phone:** (321) 453-2267

## Contact information

- **Practice address:** 30 FORTENBERRY RD, MERRITT ISLAND, FL 32952-3616
- **Practice address phone:** (321) 453-2267
- **Practice address fax:** (321) 453-8019
- **Mailing address:** 30 FORTENBERRY RD, MERRITT ISLAND, FL 32952-3616
- **Mailing address phone:** (321) 453-2267
- **Mailing address fax:** (321) 453-8019

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | 0069902 | FL | Yes |

## Other

- **Enumeration date:** 12/04/2007
- **Last updated:** 11/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0069902 | LICENSE | FL |
| 01 | — | 28957A | MEDICARE ID | FL |
| 01 | — | K5220 | GROUP ID | FL |