Healthcare Provider Details

I. General information

NPI: 1710939970
Provider Name (Legal Business Name): RACQUEL VERA-MCLEAN PHD, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACQUEL VERA PH.D., APRN

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 02/10/2024
Certification Date: 02/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CORAL HILLS DR STE 207
CORAL SPRINGS FL
33065-4139
US

IV. Provider business mailing address

5550 GLADES RD STE 500
BOCA RATON FL
33431-7277
US

V. Phone/Fax

Practice location:
  • Phone: 954-344-5590
  • Fax: 954-755-8387
Mailing address:
  • Phone: 954-271-4484
  • Fax: 954-869-2542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP2724872
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN2724972
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN2724872
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberAPRN2724872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: