Provider Demographics
NPI:1710939970
Name:VERA-MCLEAN, RACQUEL (PHD, APRN)
Entity Type:Individual
Prefix:DR
First Name:RACQUEL
Middle Name:
Last Name:VERA-MCLEAN
Suffix:
Gender:F
Credentials:PHD, APRN
Other - Prefix:DR
Other - First Name:RACQUEL
Other - Middle Name:
Other - Last Name:VERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, APRN
Mailing Address - Street 1:5550 GLADES RD STE 500
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7277
Mailing Address - Country:US
Mailing Address - Phone:954-271-4484
Mailing Address - Fax:954-869-2542
Practice Address - Street 1:3100 CORAL HILLS DR STE 207
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4139
Practice Address - Country:US
Practice Address - Phone:954-344-5590
Practice Address - Fax:954-755-8387
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2724872363L00000X
FLAPRN2724972363LP2300X
FLAPRN2724872363LP2300X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIK373ZMedicaid
FL016337100OtherMEDICAID NUMBER