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Individual

DR. ADELA M DE VERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1441 HERITAGE BLVD, IMMOKALEE, FL 34142-2260
(239) 658-3000
Mailing address
1454 MADISON AVE W STE 106, IMMOKALEE, FL 34142-2200
(239) 658-3000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13372
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00249001
MEDICARE PTAN
NH
05
30207073
NH
Enumeration date
07/16/2007
Last updated
04/26/2023
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