Provider Demographics
NPI:1043402670
Name:NUNEZ, JOSEFINA C (OT)
Entity Type:Individual
Prefix:
First Name:JOSEFINA
Middle Name:C
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:JOSEFINA
Other - Middle Name:C
Other - Last Name:NUNEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:10420 RAMBLE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-6494
Mailing Address - Country:US
Mailing Address - Phone:352-596-6632
Mailing Address - Fax:
Practice Address - Street 1:10420 RAMBLE RIDGE CT
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34613-6494
Practice Address - Country:US
Practice Address - Phone:352-596-6632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT1896225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT1896OtherFLORIDA STATE