Individual provider Active NPI

Benjamin Nathan Serrano

  • Certified Registered Nurse Anesthetist
  • Coral Springs, FL
National Provider Identifier
1417795774
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209036358 Issued in IL
Practice address
3000 Coral Hills Dr
Coral Springs, FL 33065-4108
Phone
(954) 344-3000
NPI assigned
Jul 19, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 56364 ID
Certified Registered Nurse Anesthetist 367500000X 209036358 IL Primary

Addresses

Primary practice location

3000 Coral Hills Dr
Coral Springs, FL 33065-4108

Mailing address

11300 NE 2ND Ave
Miami Shores, FL 33161-6695

Other practice location 1

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

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
56364IDMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1417795774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 NE 2ND AVE",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331616695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CORAL HILLS DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654108",
            "telephone_number": "954-344-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "BENJAMIN",
        "middle_name": "NATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-19",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "ID",
            "license": "56364",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209036358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.