Provider Demographics
NPI:1558968008
Name:VERA MEDICAL PRACTICE LLC
Entity Type:Organization
Organization Name:VERA MEDICAL PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ONCOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VERA GIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-300-6063
Mailing Address - Street 1:10730 NW 66TH ST APT 312
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3708
Mailing Address - Country:US
Mailing Address - Phone:786-414-0344
Mailing Address - Fax:
Practice Address - Street 1:6741 CORAL WAY STE 44
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1767
Practice Address - Country:US
Practice Address - Phone:786-300-6063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty