Healthcare Provider Details
I. General information
NPI: 1780090241
Provider Name (Legal Business Name): JONATAN DAVID NUNEZ BRETON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/05/2014
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
THE HEART CENTER AT MERCY 846 9TH AVENUE SE
CEDAR RAPIDS IA
52401
US
IV. Provider business mailing address
THE HEART CENTER AT MERCY 846 9TH AVENUE SE
CEDAR RAPIDS IA
52401
US
V. Phone/Fax
- Phone: 319-832-2328
- Fax: 319-832-1168
- Phone: 319-832-2328
- Fax: 319-832-1168
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | MD474472 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | 19791 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | MD49245 |
| License Number State | IA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: