Provider Demographics
NPI:1609398643
Name:NUNEZ, CATHY LEE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LEE
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13331 NW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2905
Mailing Address - Country:US
Mailing Address - Phone:754-214-1431
Mailing Address - Fax:
Practice Address - Street 1:13331 NW 10TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2905
Practice Address - Country:US
Practice Address - Phone:754-214-3062
Practice Address - Fax:754-214-3062
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ7463235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSZ7463OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH