=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962329086
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | OLGA LIDIA NUNEZ CRUZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2026
-----------------------------------------------------
Last Update Date | 06/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6930 TOWN HARBOUR BLVD APT 2512
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33433-5097
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-327-9239
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6930 TOWN HARBOUR BLVD APT 2512
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33433-5097
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-327-9239
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | 17767I
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------