Individual
MR. SEREN DEVOL WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4612 N HABANA AVE, 2ND FL, TAMPA, FL 33614-7101
(813) 321-6580
(813) 321-6581
Mailing address
3000 MEDICAL PARK DR STE 320, TAMPA, FL 33613-4681
(813) 336-5766
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9103985
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292621100
—
FL
Enumeration date
10/27/2006
Last updated
03/09/2026
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