Healthcare Provider Details

I. General information

NPI: 1134225097
Provider Name (Legal Business Name): JOSE A NUNEZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SW 27TH AVE STE 200
MIAMI FL
33145-2457
US

IV. Provider business mailing address

PO BOX 144316
CORAL GABLES FL
33114-4316
US

V. Phone/Fax

Practice location:
  • Phone: 305-446-3845
  • Fax: 305-446-3847
Mailing address:
  • Phone: 305-446-3845
  • Fax: 305-446-3847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME-0066450
License Number StateFL

VIII. Authorized Official

Name: JOSE ALBERTO NUNEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 305-446-3845