Provider Demographics
NPI:1609304450
Name:PEREZ-NUNEZ, DIANA JANE (APRN,PMHNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:JANE
Last Name:PEREZ-NUNEZ
Suffix:
Gender:F
Credentials:APRN,PMHNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5083
Mailing Address - Country:US
Mailing Address - Phone:561-846-0367
Mailing Address - Fax:561-461-6255
Practice Address - Street 1:2900 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5083
Practice Address - Country:US
Practice Address - Phone:561-846-0367
Practice Address - Fax:561-461-6255
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3193932363LF0000X
FLAPRN3193932363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102504200Medicaid