Provider Demographics
NPI:1205307709
Name:NUNEZ, CARMEN SOCORRO
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:SOCORRO
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 WINDSONG LN
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-5753
Mailing Address - Country:US
Mailing Address - Phone:727-277-3941
Mailing Address - Fax:727-264-6485
Practice Address - Street 1:8900 WINDSONG LN
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-5753
Practice Address - Country:US
Practice Address - Phone:727-277-3941
Practice Address - Fax:727-264-6485
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-09
Last Update Date:2018-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant