Keith Richard Serrago, RPH,PHARMD,CPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS18542 Issued in FL

Practice address

1026 SW Bayshore Blvd
Port St Lucie, FL 34983-2400

Phone

(772) 344-0409

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

Practice roles

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.

• Bayshore Pharmacy

  • Community/Retail Pharmacy
  • Port Saint Lucie, FL
  • NPI 1750723722
  NPD (past) Authorized official

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1811022684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 SW BAYSHORE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349832400",
            "telephone_number": "772-344-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 SW BAYSHORE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349832400",
            "telephone_number": "772-344-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRAGO",
        "first_name": "KEITH",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "RPH,PHARMD,CPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS18542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101097200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serenique Homecare Solutions, LLC
• Serenity Primary Care LLC
• Serenity Senior Care LLC
• Serenity Shore Assisted Living Facility LLC
• Yelena Sergiyenko, AP
• Aien Vanesa Serrano
• Lysseeveth Serrano
• Seven Heaven Home Care LLC
• Debbie Michelle Sevilla, MD
• Bobby Ajay Shah, M.D.

• Pharmacist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.