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General NPI Number Information
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NPI Number | 1821812355
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Entity Type | Individual
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Provider Name | AQUIANY LOPEZ NUNEZ
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Gender | Female
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | CALLE EL MORRO 44, PUERTO PLATA
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City | PUERTO PLATA
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State | DOMINICAN REPUBLIC
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Zip | 57000
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Country | DO
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Telephone | 809-891-9227
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Fax |
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Provider Business Mailing Address
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Address Line | 2007 E 23RD AVE
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City | TAMPA
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State | FL
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Zip | 33605-1929
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Country | US
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Telephone | 972-330-6955
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 228729
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License Number State | FL
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