Healthcare Provider Details

I. General information

NPI: 1003632068
Provider Name (Legal Business Name): VANESSA VERAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 W FLAGLER ST STE 2I
WEST MIAMI FL
33144-2069
US

IV. Provider business mailing address

11850 SW 186TH ST
MIAMI FL
33177-3271
US

V. Phone/Fax

Practice location:
  • Phone: 786-715-9183
  • Fax:
Mailing address:
  • Phone: 786-250-7361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11036369
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: