MEDICARE: SONIA M CANAVES NUNEZ MD

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	2084N0400X	Neurology Physician	ME0050280	FL
2	2084D0003X	Diagnostic Neuroimaging (Psychiatry & Neurology) Physician	ME0050280	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4122062	OTHER	FL	AETNA
2	0581875	OTHER	FL	UNITED HEALTH CARE
3	05739	OTHER	FL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437184843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA M CANAVES NUNEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 33225
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33420-3225
Country	:	US
Telephone Number	:	561-624-0702
Fax Number	:	561-624-0773

Provider Business Practice Location Address
First Line	:	601 UNIVERSITY BLVD
Second Line	:	SUITE 205
City	:	JUPITER
State	:	FL
Zip	:	33458-2788
Country	:	US
Telephone Number	:	561-624-0702
Fax Number	:	561-624-0773

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	11/08/2011

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