Individual provider Active NPI

Maria Leticia Vera

  • Health Psychologist
  • Fort Lauderdale, FL
National Provider Identifier
1720590979
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health PsychologistTaxonomy code 103TH0004X
Practice address
3113 Stirling Rd Ste 204
Fort Lauderdale, FL 33312-6547
Phone
(954) 842-3501
Fax
(954) 206-0906
NPI assigned
Oct 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X FL
Behavior Technician 106S00000X
Health PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TH0004X Primary

Addresses

Primary practice location

3113 Stirling Rd Ste 204
Fort Lauderdale, FL 33312-6547

Mailing address

3113 Stirling Rd Ste 204
Fort Lauderdale, FL 33312-6547
Phone (954) 842-3501

Other identifiers 1

IdentifierTypeStateIssuer
V656552688040OtherFLDRIVER LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1720590979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 STIRLING RD STE 204",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126547",
            "telephone_number": "954-842-3501",
            "fax_number": "954-206-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 STIRLING RD STE 204",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126547",
            "telephone_number": "954-842-3501",
            "fax_number": "954-206-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERA",
        "first_name": "MARIA",
        "middle_name": "LETICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "V656552688040",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.