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NPI Code Detail

MEDICARE: VERA HEALTHCARE FLORIDA LLC

MEDICARE: VERA HEALTHCARE FLORIDA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1396501755
Entity Type Code : Organization
Provider Name (Legal Business Name) : VERA HEALTHCARE FLORIDA LLC
Provider Business Mailing Address
First Line : 100 E PINE ST STE 110
Second Line :
City : ORLANDO
State : FL
Zip : 32801-2759
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 E PINE ST STE 110
Second Line :
City : ORLANDO
State : FL
Zip : 32801-2759
Country : US
Telephone Number : 239-221-1144
Fax Number : 239-212-1257
Authorized Official
Title or Position : CEO
Name : DHARMA TEJA NUKARAPU
Credential :
Telephone Number : 919-916-8989
Provider Enumeration Date : 02/23/2024
Last Update Date : 04/11/2024

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Directions to “VERA HEALTHCARE FLORIDA LLC ” Practice Location

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