Provider Demographics
NPI:1376881300
Name:JEANNIE C. NUNEZ, PSY.D.
Entity Type:Organization
Organization Name:JEANNIE C. NUNEZ, PSY.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-374-4747
Mailing Address - Street 1:15861 SURREY CIR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-2570
Mailing Address - Country:US
Mailing Address - Phone:954-374-4747
Mailing Address - Fax:877-309-7271
Practice Address - Street 1:1941 NW 150TH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2874
Practice Address - Country:US
Practice Address - Phone:954-374-4747
Practice Address - Fax:877-309-7271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty