Provider Demographics
NPI:1164222576
Name:HERRERA VERA, HASSEF ANDRES
Entity type:Individual
Prefix:
First Name:HASSEF
Middle Name:ANDRES
Last Name:HERRERA 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 1:2209 NE 13TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-4406
Mailing Address - Country:US
Mailing Address - Phone:239-324-1107
Mailing Address - Fax:
Practice Address - Street 1:2209 NE 13TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-4406
Practice Address - Country:US
Practice Address - Phone:239-324-1107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician