MEDICARE: MARLYNN 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	207V00000X	Obstetrics & Gynecology Physician	2004012768	MO
2	207V00000X	Obstetrics & Gynecology Physician	ME96197	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	78195	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649275249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLYNN NUNEZ MD

Provider Business Mailing Address
First Line	:	4671 S CONGRESS AVE
Second Line	:	SUITE 100B
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4783
Country	:	US
Telephone Number	:	561-434-0111
Fax Number	:	561-296-3533

Provider Business Practice Location Address
First Line	:	4671 S CONGRESS AVE
Second Line	:	SUITE 100B
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4783
Country	:	US
Telephone Number	:	561-434-0111
Fax Number	:	561-296-3533

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	01/10/2014

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Directions to “ MARLYNN NUNEZ MD” Practice Location

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