Provider Demographics
NPI:1043785827
Name:NUNEZ, MARIO A (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:A
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 MAXIMILIAN DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33543-6555
Mailing Address - Country:US
Mailing Address - Phone:813-391-7603
Mailing Address - Fax:
Practice Address - Street 1:3306 US HIGHWAY 19 UNIT B
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-1846
Practice Address - Country:US
Practice Address - Phone:727-312-5190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor