Provider Demographics
NPI:1508821265
Name:NUNES, CHRISTOPHER SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:NUNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8057 SPYGLASS HILL RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8565
Mailing Address - Country:US
Mailing Address - Phone:321-241-4877
Mailing Address - Fax:321-241-4879
Practice Address - Street 1:8057 SPYGLASS HILL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8565
Practice Address - Country:US
Practice Address - Phone:321-241-4877
Practice Address - Fax:321-241-4879
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79204207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261852400Medicaid
110225558OtherRAIL ROAD MEDICARE
110225558OtherRAIL ROAD MEDICARE
FL261852400Medicaid