Provider Demographics
NPI:1619396272
Name:RIVERA, VERA MARIE (NP-C)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:MARIE
Last Name:RIVERA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SW SAINT LUCIE WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2109
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:401-652-9787
Practice Address - Street 1:1300 SW SAINT LUCIE WEST BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2109
Practice Address - Country:US
Practice Address - Phone:772-878-7078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC004365363LF0000X
NH087808-23363LF0000X
NC5006852363LF0000X
RIAPRN03173363LF0000X
MARN2363521363LF0000X
KY3017587363LF0000X
OH.0031503363LF0000X
DC500002202363LF0000X
MECNP221133363LF0000X
FL11013506363LF0000X
VT101.0136564363LF0000X
KS53-81049041363LF0000X
DELG-0011983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily