| Entity Name: | SERENE MEDICAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 May 2024 (9 months ago) |
| Document Number: | L24000210777 |
| Mail Address: | 2900 W CYPRESS CREEK RD, SUITE 10, FORT LAUDERDALE, FL, 33309, UN |
| Address: | 269 N UNIVERSITY DRIVE, STE 269 C, PEMBROKE PINES, FL, 33024, UN |
| ZIP code: | 33024 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003663089 | 2024-05-06 | 2024-06-17 | 269 N UNIVERSITY DR STE 269C, PEMBROKE PINES, FL, 330246715, US | 8080 PASADENA BLVD STE A, PEMBROKE PINES, FL, 330243537, US | |||||||||||||||||||||
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| Phone | +1 954-437-9070 |
| Fax | 9544378193 |
Authorized person
| Name | MRS. MELANIO BRUCETA |
| Role | CLINICAL DIRECTOR |
| Phone | 9543436561 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 116261500 |
| State | FL |
| Name | Role |
|---|---|
| PATRICIA DENIS CONSULTING, INC | Agent |
| Name | Role | Address |
|---|---|---|
| DENIS PATRICIA | Manager | 269 N UNIVERSITY DRIVE, PEMBROKE PINES, FL, 33024 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-05-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
