Provider Demographics
NPI:1043873193
Name:NUNEZ, SYLVIA
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 URB PARQUE ANA LUISA
Mailing Address - Street 2:CARR 14
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-644-7119
Mailing Address - Fax:
Practice Address - Street 1:11 URB PARQUE ANA LUISA
Practice Address - Street 2:CARR 14
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-0079
Practice Address - Country:US
Practice Address - Phone:787-644-7119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4151103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1072Other2633243
PR2633243Other2633243