Healthcare Provider Details

I. General information

NPI: 1548668890
Provider Name (Legal Business Name): JOSE R. NUNEZ ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2014
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 BLUE LAGOON DR SUITE 365
MIAMI FL
33126-2079
US

IV. Provider business mailing address

1621 SW 107TH AVE
MIAMI FL
33165-7344
US

V. Phone/Fax

Practice location:
  • Phone: 786-322-7358
  • Fax: 786-322-7329
Mailing address:
  • Phone: 786-422-6525
  • Fax: 786-621-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9305943
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: