Provider Demographics
NPI:1952648933
Name:LUIS C VERA PLLC
Entity Type:Organization
Organization Name:LUIS C VERA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER-MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:VERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-297-4012
Mailing Address - Street 1:9306 WHISPERING MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7531
Mailing Address - Country:US
Mailing Address - Phone:321-297-4012
Mailing Address - Fax:
Practice Address - Street 1:9306 WHISPERING MEADOWS LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-7531
Practice Address - Country:US
Practice Address - Phone:321-297-4012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8736111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89623ZOtherMEDICARE PROVIDER #