Sergio H. Vallejo M. D. , P. a.

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

ME23925 Issued in FL

Legal business name

SERGIO H. VALLEJO M. D. , P. A.

Practice address

1543 Lakeland Hills Blvd
Lakeland, FL 33805-3246

Phone

(863) 688-0512

Fax

(863) 686-6895

NPI assigned

Feb 5, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Diane Jordan

Title

Secretary

Phone

(863) 688-0512

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sandra L Stutzman, ARNP

  • Acute Care Nurse Practitioner
  • Tampa, FL
  • NPI 1356381768
  NPD (past)

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1710165469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053246",
            "telephone_number": "863-688-0512",
            "fax_number": "863-686-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053246",
            "telephone_number": "863-688-0512",
            "fax_number": "863-686-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGIO H. VALLEJO M. D. , P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "863-688-0512",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "ME23925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258723800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "K1372",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sergio B. Seoane, M.D.
• Solmaris Sepulveda Rodriguez, PTA
• Serenity Wellness Services Enterprise LLC
• Sergio B Seoane MD PA
• Sergio B. Seoane, M.D.,P.a.
• Karen Serna, ARNP
• Donald I Serot, MD
• Danelis Yelie Serrano Muniz, COTA/L
• Reinaldo Serrano, D.C.
• Sugeidi Johana Serrano

• Legal Medicine in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Legal Medicine in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.