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General NPI Number Information
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NPI Number | 1982473229
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Entity Type | Individual
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Provider Name | JONATHAN MANUEL NUNEZ FERNANDEZ
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Gender | Male
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Dates
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Enumeration Date | 12/28/2023
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 5601 ARRINGDON PARK DR STE 150
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City | MORRISVILLE
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State | NC
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Zip | 27560-5677
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Country | US
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Telephone | 919-385-6510
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Fax |
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Provider Business Mailing Address
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Address Line | 3277 MILL RUN
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City | RALEIGH
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State | NC
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Zip | 27612-5211
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Country | US
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Telephone | 787-344-0237
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P22796
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License Number State | NC
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