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Organization

SERENE MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LERISSA ANTONIO MD (SOLE MEMBER)
(912) 272-5549
Entity
Organization

Contact information

Practice address
107 SEAGRASS STATION RD, BLUFFTON, SC 29910-9549
(843) 836-8200
Mailing address
1 SOUNDING POINT RETREAT, SAVANNAH, GA 31411-2839
(912) 272-5549

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1730406778
NPI
Enumeration date
04/16/2020
Last updated
04/16/2020
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