Provider Demographics
NPI:1255869491
Name:NUNEZ, JUAN P (PT)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:P
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 SW 170TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-4823
Mailing Address - Country:US
Mailing Address - Phone:786-253-7699
Mailing Address - Fax:786-288-0794
Practice Address - Street 1:7600 SW 170TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-4823
Practice Address - Country:US
Practice Address - Phone:786-253-7699
Practice Address - Fax:786-288-0794
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT4826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist