MEDICARE: JUNIOR NUNEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist

General Provider Information

NPI Number	:	1326240227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNIOR NUNEZ

Provider Business Mailing Address
First Line	:	497 AVE EMILIANO POL
Second Line	:	PMB 930
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	497 AVE EMILIANO POL
Second Line	:	PMB 930
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5602
Country	:	US
Telephone Number	:	787-938-6447
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2007
Last Update Date	:	07/08/2007

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