NPIMap

Organization Active NPI

Serenity Medical Group LLC

  • Clinic/Center
  • Tampa, FL
National Provider Identifier
1548844913
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SERENITY MEDICAL GROUP LLC
Practice address
4801 George Rd Ste 190
Tampa, FL 33634-6200
Phone
(813) 545-0682
NPI assigned
May 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Authorized official

Name
Mr. Robert Scott Bennett, MBA
Title
Officer
Phone
(813) 545-0682

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4801 George Rd Ste 190
Tampa, FL 33634-6200

Mailing address

4801 George Rd Ste 190
Tampa, FL 33634-6200
Phone (813) 545-0682

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1548844913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 GEORGE RD STE 190",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346200",
            "telephone_number": "813-545-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 GEORGE RD STE 190",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346200",
            "telephone_number": "813-545-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "813-545-0682",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.