MEDICARE: GLEN NUNES FNP

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	363LA2200X	Adult Health Nurse Practitioner	11044867	FL

General Provider Information

NPI Number	:	1962361980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLEN NUNES FNP

Provider Business Mailing Address
First Line	:	2720 S OAKLAND FOREST DR APT 1209
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33309-5685
Country	:	US
Telephone Number	:	561-305-7576
Fax Number	:

Provider Business Practice Location Address
First Line	:	2720 S OAKLAND FOREST DR APT 1209
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33309-5685
Country	:	US
Telephone Number	:	561-305-7576
Fax Number	:

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

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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