Provider Demographics
NPI:1689638827
Name:NUNEZ-CUBILLAS, ALBERTO (PA-C)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:NUNEZ-CUBILLAS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21686
Mailing Address - Street 2:C/O UNITED SURGICAL ASSISTANTS
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-1686
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12880 COMMODITY PL
Practice Address - Street 2:C/O UNITED SURGICAL ASSISTANTS
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-3101
Practice Address - Country:US
Practice Address - Phone:813-865-1340
Practice Address - Fax:813-865-1348
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101680363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00158390OtherRAILROAD MEDICARE
FL291085300Medicaid
P00158390OtherRAILROAD MEDICARE
FLE6059Medicare ID - Type Unspecified