Provider Demographics
NPI:1083792006
Name:ROBERT, VERA M (DO)
Entity Type:Individual
Prefix:DR
First Name:VERA
Middle Name:M
Last Name:ROBERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 19TH ST SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-4724
Mailing Address - Country:US
Mailing Address - Phone:239-353-1015
Mailing Address - Fax:239-455-9906
Practice Address - Street 1:12565 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-5243
Practice Address - Country:US
Practice Address - Phone:239-455-9919
Practice Address - Fax:239-455-9906
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8077207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A75570Medicaid
CA020A75570Medicaid
FLH01299Medicare UPIN