Provider Demographics
NPI:1821658170
Name:RODRIGUEZ DE VERA, MARIA J (DNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:J
Last Name:RODRIGUEZ DE VERA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3361 BELLINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7168
Mailing Address - Country:US
Mailing Address - Phone:407-346-8517
Mailing Address - Fax:
Practice Address - Street 1:10931 DYLAN LOREN CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4449
Practice Address - Country:US
Practice Address - Phone:407-218-4444
Practice Address - Fax:321-284-1514
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002814363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11002814OtherFLORIDA BOARD OF NURSING