Organization Active NPI

Serenity Life Counseling Center LLC

  • Addiction (Substance Use Disorder) Counselor
  • Kissimmee, FL
National Provider Identifier
1346725413
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
SERENITY LIFE COUNSELING CENTER LLC
Practice address
804 N Hoagland Blvd
Kissimmee, FL 34741-4518
Phone
(407) 797-7298
Fax
(407) 386-3201
NPI assigned
Sep 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Oswaldo Jose Perez, MH16250NPI 1306266879
Title
Ceo
Phone
(407) 797-7298

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

804 N Hoagland Blvd
Kissimmee, FL 34741-4518

Mailing address

111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (407) 797-7298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200106000122 FL Part B Supplier - Clinic/Group Practice 7618301342 Receives reassigned benefits from 3 practitioners
Practice locations: Kissimmee, FL

National Provider Directory

National Provider Directory

Locations

804 N Hoagland Blvd
Kissimmee, FL 34741
Phone (407) 797-7298

672 N Semoran Blvd
Ste 104
Orlando, FL 32807
Phone (407) 750-4557

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1346725413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N ORANGE AVE STE 800",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328012381",
            "telephone_number": "407-797-7298",
            "fax_number": "407-386-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 N HOAGLAND BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414518",
            "telephone_number": "407-797-7298",
            "fax_number": "407-386-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY LIFE COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-25",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "OSWALDO",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-797-7298",
        "authorized_official_credential": "MH16250"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.