Individual provider Active NPI

Kaylee Serrano

  • Community Psychiatric/Mental Health Clinical Nurse Specialist
  • Longwood, FL
National Provider Identifier
1023845468
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0812X
License
1669047734 Issued in FL
Practice address
2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534
Phone
(407) 215-0095
NPI assigned
Sep 18, 2024
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Psychiatric/Mental Health Clinical Nurse Specialist 364SP0812X 1669047734 FL Primary

Addresses

Primary practice location

2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534

Mailing address

10130 Richardson CT
Orlando, FL 32825-3826
Phone (407) 802-0067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1669047734FLMDCommunity Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1023845468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 RICHARDSON CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253826",
            "telephone_number": "407-802-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 N RONALD REAGAN BLVD STE 116",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503534",
            "telephone_number": "407-215-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "KAYLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0812X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Community",
            "state": "FL",
            "license": "1669047734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.