Wallen, Seren Devol

Wallen, Seren Devol is an individual health care provider with primary practice located at 4612 N Habana Ave 2Nd Fl, Tampa FL 33614-7101. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Wallen, Seren Devol can be contacted via phone (813) 321-6580.

Contact Information

Primary practice address
4612 N Habana Ave 2Nd Fl Tampa FL 33614-7101
Phone: (813) 321-6580
Fax: (813) 321-6581
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9103985 Florida

Profile Details

NPI number 1447336235
LBN Legal business name Wallen, Seren Devol
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated May 11th, 2023 - about 3 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 1447336235 NPPES
Florida MEDICAID 292621100

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