Provider Demographics
NPI:1043518855
Name:VERA, ZEUS MEDINA (DPT)
Entity type:Individual
Prefix:
First Name:ZEUS
Middle Name:MEDINA
Last Name:VERA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18840 NW 57TH AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-7027
Mailing Address - Country:US
Mailing Address - Phone:786-877-9416
Mailing Address - Fax:
Practice Address - Street 1:18840 NW 57TH AVE APT 306
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-7027
Practice Address - Country:US
Practice Address - Phone:786-877-9416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25873225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008608300Medicaid
FL008608300Medicaid