Provider Demographics
NPI:1659923993
Name:PAZ, ABIGAIL BUNCAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:BUNCAN
Last Name:PAZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1291 NE 102ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2617
Mailing Address - Country:US
Mailing Address - Phone:786-213-1913
Mailing Address - Fax:
Practice Address - Street 1:1291 NE 102ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2617
Practice Address - Country:US
Practice Address - Phone:786-213-1913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9476965163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse