Healthcare Provider Details

I. General information

NPI: 1235690215
Provider Name (Legal Business Name): ALLEN MACHADO NUNEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2019
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21644 STATE ROAD 7
BOCA RATON FL
33428-1899
US

IV. Provider business mailing address

10863 NW 83RD ST UNIT 2
DORAL FL
33178-1687
US

V. Phone/Fax

Practice location:
  • Phone: 713-505-4821
  • Fax:
Mailing address:
  • Phone: 713-505-4821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME151805
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: