Healthcare Provider Details

I. General information

NPI: 1881079150
Provider Name (Legal Business Name): EURI DE JESUS FERNANDEZ NUNEZ SR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JESUS T. PINERO BUILDING, UNIT 8 92JV+5P9, CLL MOLINILLO
CAROLINA PR
00986
US

IV. Provider business mailing address

JESUS T. PINERO BUILDING, UNIT 8
CAROLINA PR
00986
US

V. Phone/Fax

Practice location:
  • Phone: 787-626-3322
  • Fax:
Mailing address:
  • Phone: 787-626-3322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number19422
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number19422
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19422
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: