Provider Demographics
NPI:1770143752
Name:VERA-GIMON, RAUL (MD)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:VERA-GIMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 W OAK ST STE 100
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4936
Mailing Address - Country:US
Mailing Address - Phone:407-933-2775
Mailing Address - Fax:407-933-8549
Practice Address - Street 1:737 W OAK ST STE 100
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4936
Practice Address - Country:US
Practice Address - Phone:407-933-2775
Practice Address - Fax:407-933-8549
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL135582207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology