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General NPI Number Information
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NPI Number | 1558968008
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Entity Type | Organization
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Legal Business Name | VERA MEDICAL PRACTICE LLC
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 6741 CORAL WAY STE 44
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City | MIAMI
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State | FL
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Zip | 33155-1767
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Country | US
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Telephone | 786-300-6063
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Fax |
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Provider Business Mailing Address
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Address Line | 10730 NW 66TH ST APT 312
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City | DORAL
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State | FL
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Zip | 33178-3708
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Country | US
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Telephone | 786-414-0344
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Fax |
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Authorized Official
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Title or Position | MEDICAL ONCOLOGY
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Name | DR. RAUL VERA GIMON
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Credential | MD
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Telephone | 786-300-6063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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