Healthcare Provider Details

I. General information

NPI: 1184176521
Provider Name (Legal Business Name): DAYRON NUNEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8404 WILSKY BLVD STE 110
TAMPA FL
33615-1515
US

IV. Provider business mailing address

1033 TANGELO ST
LAKELAND FL
33803-1983
US

V. Phone/Fax

Practice location:
  • Phone: 813-374-3906
  • Fax:
Mailing address:
  • Phone: 305-992-9786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number23-270603
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-2582084
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: