Healthcare Provider Details

I. General information

NPI: 1033710587
Provider Name (Legal Business Name): VANESSA ELENA VERA MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10045 S DIXIE HWY
PINECREST FL
33156-3145
US

IV. Provider business mailing address

10045 S DIXIE HWY
PINECREST FL
33156-3145
US

V. Phone/Fax

Practice location:
  • Phone: 786-888-2480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11009549
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: