Provider Demographics
NPI:1881630382
Name:VERDECIA, LUIS FELIPE SR (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:FELIPE
Last Name:VERDECIA
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 NW 42ND AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4172
Mailing Address - Country:US
Mailing Address - Phone:305-204-0333
Mailing Address - Fax:
Practice Address - Street 1:15141 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-3949
Practice Address - Country:US
Practice Address - Phone:305-204-0333
Practice Address - Fax:305-359-7546
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81400208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260500700Medicaid
FLH36045Medicare UPIN
FL260500700Medicaid