Provider Demographics
NPI:1780252411
Name:A SERENE HYDRATION & WELLNESS SPA, PLLC
Entity type:Organization
Organization Name:A SERENE HYDRATION & WELLNESS SPA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SENATUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-412-6756
Mailing Address - Street 1:2393 S CONGRESS AVE # 211
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7628
Mailing Address - Country:US
Mailing Address - Phone:561-412-6756
Mailing Address - Fax:
Practice Address - Street 1:2393 S CONGRESS AVE # 211
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-7628
Practice Address - Country:US
Practice Address - Phone:561-412-6756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care