Provider Demographics
NPI:1871850412
Name:VERA HERNANDEZ, ZULAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ZULAYNE
Middle Name:
Last Name:VERA HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ZULAYNE
Other - Middle Name:
Other - Last Name:VERA HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3000 MEDICAL PARK DR STE 450
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4681
Mailing Address - Country:US
Mailing Address - Phone:813-972-5420
Mailing Address - Fax:813-977-2021
Practice Address - Street 1:3000 MEDICAL PARK DR STE 450
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4681
Practice Address - Country:US
Practice Address - Phone:813-972-5420
Practice Address - Fax:813-977-2021
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18437208D00000X
FLACN1191208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105889500Medicaid