Provider Demographics
NPI:1902057144
Name:VERA, FERNANDO J
Entity Type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:J
Last Name:VERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8207 SPLIT RAIL LN
Mailing Address - Street 2:APT 42A
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-2608
Mailing Address - Country:US
Mailing Address - Phone:347-682-9395
Mailing Address - Fax:
Practice Address - Street 1:8207 SPLIT RAIL LN
Practice Address - Street 2:APT 42A
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-2608
Practice Address - Country:US
Practice Address - Phone:347-682-9395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist