Provider Demographics
NPI:1013579002
Name:NUNEZ, ALICIA (APRN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W BROADWAY ST STE 206
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9262
Mailing Address - Country:US
Mailing Address - Phone:407-542-0100
Mailing Address - Fax:407-992-7701
Practice Address - Street 1:1000 W BROADWAY ST STE 206
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9262
Practice Address - Country:US
Practice Address - Phone:407-542-0100
Practice Address - Fax:407-992-7701
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002973207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology