Provider Demographics
NPI:1821094665
Name:VERMA, ANIL G (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:G
Last Name:VERMA
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 S SEACREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6789
Mailing Address - Country:US
Mailing Address - Phone:561-369-7865
Mailing Address - Fax:561-369-7169
Practice Address - Street 1:2580 S SEACREST BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6789
Practice Address - Country:US
Practice Address - Phone:561-369-7865
Practice Address - Fax:561-369-7169
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051748207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061405000Medicaid
FL650479464OtherTAX ID
FL061405000Medicaid
FLD84939Medicare UPIN