Provider Demographics
NPI:1104858968
Name:STRICEVIC, VERA (MD)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:STRICEVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 109TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-1821
Mailing Address - Country:US
Mailing Address - Phone:239-513-1002
Mailing Address - Fax:239-513-1915
Practice Address - Street 1:878 109TH AVE N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1821
Practice Address - Country:US
Practice Address - Phone:239-513-1002
Practice Address - Fax:239-513-1915
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL94388207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274207100Medicaid
FL35115OtherBLUE CROSS BLUE SHIELD
FL35115OtherBLUE CROSS BLUE SHIELD
FLU6662YMedicare PIN