Provider Demographics
NPI:1710039292
Name:VERA, RAFAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:VERA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11545 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1002
Mailing Address - Country:US
Mailing Address - Phone:305-598-7676
Mailing Address - Fax:305-598-7676
Practice Address - Street 1:11545 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1002
Practice Address - Country:US
Practice Address - Phone:305-598-7676
Practice Address - Fax:305-598-7676
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN139251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice