Provider Demographics
NPI:1346228434
Name:VERA, TOMAS (ATC)
Entity Type:Individual
Prefix:
First Name:TOMAS
Middle Name:
Last Name:VERA
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1742 JEWEL DRIVE
Mailing Address - Street 2:RACIMO RANCHES
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240
Mailing Address - Country:US
Mailing Address - Phone:941-341-0415
Mailing Address - Fax:
Practice Address - Street 1:1742 JEWEL DRIVE
Practice Address - Street 2:RACIMO RANCHES
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240
Practice Address - Country:US
Practice Address - Phone:941-341-0415
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL18152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer