Individual
LUIS E REYES SERRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1456 RIDGELANE RD, CLEARWATER, FL 33755-1261
(727) 776-1728
Mailing address
1456 RIDGELANE RD, CLEARWATER, FL 33755-1261
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
11016976
FL
Other
Enumeration date
04/09/2022
Last updated
04/09/2022
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