Healthcare Provider Details

I. General information

NPI: 1053234534
Provider Name (Legal Business Name): JULIAN GENARO NUNEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 BRANDON AVE
CHARLOTTESVILLE VA
22903-3312
US

IV. Provider business mailing address

212 COPELEY RD APT 1
CHARLOTTESVILLE VA
22903-1587
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-5362
  • Fax:
Mailing address:
  • Phone: 708-606-5691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: