Provider Demographics
NPI:1730140054
Name:VIERA, ROXANA P (MD)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:P
Last Name:VIERA
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 1:1951 NW FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9303
Mailing Address - Country:US
Mailing Address - Phone:772-934-6149
Mailing Address - Fax:772-934-6248
Practice Address - Street 1:875 MILITARY TRL STE 200
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5700
Practice Address - Country:US
Practice Address - Phone:561-746-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46306207Q00000X
FLME129089207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080020846Medicare PIN