Provider Demographics
NPI:1710025275
Name:NUNEZ, JOAQUIN ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAQUIN
Middle Name:ALBERTO
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOAQUIN
Other - Middle Name:ALBERTO
Other - Last Name:NUNEZ CRISTALDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2925 10TH AVE N
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3000
Mailing Address - Country:US
Mailing Address - Phone:561-969-9252
Mailing Address - Fax:561-969-9257
Practice Address - Street 1:2925 10TH AVE N
Practice Address - Street 2:SUITE 106
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-3000
Practice Address - Country:US
Practice Address - Phone:561-969-9252
Practice Address - Fax:561-969-9257
Is Sole Proprietor?:No
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0067668208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL298440OtherAVMED
FL000004205377OtherHEALTHY PALM BEACHES
FL8103245OtherCIGNA
FLVF650866720001OtherCMS
FL16758OtherHEALTHEASE
FL16758OtherSTAYWELL
FL207372OtherAMERIGROUP
FL16758OtherWELLCARE
FL26725OtherBLUECROSS AND BLUESHIELD
FLA59907F500OtherVISTA
FL8103245OtherCIGNA
FLA59907Medicare UPIN