Healthcare Provider Details

I. General information

NPI: 1801832159
Provider Name (Legal Business Name): JUAN RAFAEL NUNEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3103 COND CONDESA DEL MAR APT 603 ISLA VERDE
CAROLINA PR
00979-4900
US

IV. Provider business mailing address

COND CONDESA DEL MAR
CAROLINA PR
00979-4900
US

V. Phone/Fax

Practice location:
  • Phone: 787-268-2894
  • Fax:
Mailing address:
  • Phone: 787-268-2894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number11281
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number11281
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: