Individual provider Active NPI

Dolores Selena Serrecchia, BSN

  • Pediatric Registered Nurse
  • Miami, FL
National Provider Identifier
1043232630
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
1955832 Issued in FL
Practice address
1477 NW 8TH Ave
Miami, FL 33136-1425
Phone
(305) 547-2500
Fax
(305) 547-2673
NPI assigned
Jul 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 1955832 FL Primary

Addresses

Primary practice location

1477 NW 8TH Ave
Miami, FL 33136-1425

Mailing address

1261 NW 193Rd Ave
Pembroke Pines, FL 33029-3221
Phone (305) 547-2500

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
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
1955832FLMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043232630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 NW 193RD AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293221",
            "telephone_number": "305-547-2500",
            "fax_number": "305-547-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 NW 8TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361425",
            "telephone_number": "305-547-2500",
            "fax_number": "305-547-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRECCHIA",
        "first_name": "DOLORES",
        "middle_name": "SELENA",
        "name_prefix": "Ms.",
        "credential": "BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "FL",
            "license": "1955832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.