Provider Demographics
NPI:1053855957
Name:DAVILA NUNEZ, VIVIANA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:VIVIANA
Middle Name:
Last Name:DAVILA NUNEZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E15 C/AZUCEN S
Mailing Address - Street 2:JARDINES DE DORADO
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:E15 CALLE AZUCENAS
Practice Address - Street 2:JARDINES DE DORADO
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-5108
Practice Address - Country:US
Practice Address - Phone:787-607-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR32023367500000X
FL9312324367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered