Provider Demographics
NPI:1417066069
Name:NUNEZ, SONAL (PT, COMT)
Entity Type:Individual
Prefix:
First Name:SONAL
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:PT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20616 WHITEBUD COURT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3653
Mailing Address - Country:US
Mailing Address - Phone:813-335-0500
Mailing Address - Fax:
Practice Address - Street 1:3500 E FLETCHER AVE
Practice Address - Street 2:STE 110
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4708
Practice Address - Country:US
Practice Address - Phone:813-971-9351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT21675OtherLICENSE#