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General NPI Number Information
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NPI Number | 1093745424
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Entity Type | Individual
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Provider Name | ELIZABETH NUNEZ DMD, MST
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Gender | Female
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10000 BAY PINES BLVD
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City | BAY PINES
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State | FL
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Zip | 33744-5005
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Country | US
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Telephone | 727-398-6661
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Fax |
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Provider Business Mailing Address
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Address Line | 3326 W WALLCRAFT AVE
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City | TAMPA
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State | FL
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Zip | 33611-1947
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Country | US
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Telephone | 813-805-6991
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15464
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License Number State | FL
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