Ricardo a Serrano MD LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

0069902 Issued in FL

Legal business name

RICARDO A SERRANO MD LLC

Practice address

30 Fortenberry Rd
Merritt Island, FL 32952-3616

Phone

(321) 453-2267

Fax

(321) 453-8019

NPI assigned

Dec 4, 2007

Last updated

Nov 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ricardo A Serrano, MDNPI 1629180351

Title

Owner & MD

Phone

(321) 453-2267

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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.

• Ricardo A Serrano, MD

  • Adult Medicine Physician
  • Merritt Island, FL
  • NPI 1629180351
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1922280619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 FORTENBERRY RD",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523616",
            "telephone_number": "321-453-2267",
            "fax_number": "321-453-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 FORTENBERRY RD",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523616",
            "telephone_number": "321-453-2267",
            "fax_number": "321-453-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICARDO A SERRANO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "SERRANO",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER & MD",
        "authorized_official_telephone_number": "321-453-2267",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "0069902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "28957A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0069902",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ID",
            "identifier": "K5220",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rejuvenate With Grace, Inc.
• Restoration Medicine LLC
• Diana Harris Revolinski, RN
• Michelle Christina-Lani Reynolds, COTA
• Renee Nicole Reynolds, PTA
• Nicholas Rich
• Richard Baratta, DDS, PA
• Richard P Newman MD PA
• Kendra Marie Richardson, LCSW
• Randall Brian Rigdon, MD

• Adult Medicine Physician in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.