Provider Demographics
NPI:1497094528
Name:NUNES-VIGUERA, MONICA (ITDS)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:NUNES-VIGUERA
Suffix:
Gender:F
Credentials:ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9193 BRYDEN CT
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6479
Mailing Address - Country:US
Mailing Address - Phone:561-215-2559
Mailing Address - Fax:
Practice Address - Street 1:10570 S FEDERAL HWY
Practice Address - Street 2:STE 200
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5606
Practice Address - Country:US
Practice Address - Phone:772-380-9972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist