Provider Demographics
NPI:1043934474
Name:VERAS, JHOMARI ISABEL
Entity type:Individual
Prefix:
First Name:JHOMARI
Middle Name:ISABEL
Last Name:VERAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10741 NW 88TH AVE BLDG 12
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4612
Mailing Address - Country:US
Mailing Address - Phone:786-266-2477
Mailing Address - Fax:
Practice Address - Street 1:10741 NW 88TH AVE BLDG 12
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4612
Practice Address - Country:US
Practice Address - Phone:786-266-2477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-216211106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115734300Medicaid