Provider Demographics
NPI:1720078819
Name:VERA, ANTONIO A (MD)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:A
Last Name:VERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-0314
Mailing Address - Country:US
Mailing Address - Phone:787-780-8034
Mailing Address - Fax:787-780-8034
Practice Address - Street 1:BAYAMON MEDICAL PLZ
Practice Address - Street 2:SUITE 805
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7200
Practice Address - Country:US
Practice Address - Phone:787-780-8034
Practice Address - Fax:787-780-8034
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR6645208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics