Serrago, Keith Richard

Serrago, Keith Richard is an individual health care provider with primary practice located at 1026 Sw Bayshore Blvd , Port St Lucie FL 34983-2400. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Serrago, Keith Richard can be contacted via phone (772) 344-0409.

Contact Information

Primary practice address
1026 Sw Bayshore Blvd Port St Lucie FL 34983-2400
Phone: (772) 344-0409
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X PS18542 Florida

Profile Details

NPI number 1811022684
LBN Legal business name Serrago, Keith Richard
Credentials RPH,PHARMD,CPH
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2007
Last updated Aug 26th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811022684 NPPES
Florida MEDICAID 101097200

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