| La Serenidad Pllc | |
|
178 Tributary Cir Wilmington NC 28401-7012 | |
| (954) 544-7766 | |
| Not Available |
| Full Name | La Serenidad Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 178 Tributary Cir, Wilmington, North Carolina |
| Authorized Official Name and Position | Alan Robert Brailsford De Lopez (CEO) |
| Authorized Official Contact | 9102279797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Serenidad Pllc 178 Tributary Cir Wilmington NC 28401-7012 Ph: (954) 544-7766 | La Serenidad Pllc 178 Tributary Cir Wilmington NC 28401-7012 Ph: (954) 544-7766 |
| NPI Number | 1427707660 |
|---|---|
| Provider Enumeration Date | 03/23/2022 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Medicare PECOS PAC ID | 8426423161 |
|---|---|
| Medicare Enrollment ID | O20230411000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427707660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Alan Robert Brailsford De Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235600057 PECOS PAC ID: 1052744539 Enrollment ID: I20200520002237 |
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