Samantha Serle

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11022973 Issued in FL

Practice address

695 N Clyde Morris Blvd
Daytona Beach, FL 32114-2321

Phone

(386) 258-8722

NPI assigned

Dec 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lewis & Klancke Cardiology PA

  • Cardiovascular Disease Physician
  • Daytona Beach, FL
  • NPI 1669589263

  Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1376255059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 N CLYDE MORRIS BLVD D",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142321",
            "telephone_number": "386-258-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERLE",
        "first_name": "SAMANTHA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11022973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Sepulveda Beltran, M.D.
• Jennifer Ann Serback, PMHNP
• Serene Resolutions LLC
• Serene Sleep Solutions LLC
• Sergio M Zamora MD PLC
• Robert A Session Jr.
• Dahlia Shaaban
• April Marie Shadeed, ARNP, FNP-C
• Shady Oaks Rest Home Inc.
• Cheryl Lynette Shady

• Nurse Practitioner in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.