Provider Demographics
NPI:1780311779
Name:NUNEZ RIVERA, AXEL ALEJANDRO (MD)
Entity type:Individual
Prefix:
First Name:AXEL
Middle Name:ALEJANDRO
Last Name:NUNEZ RIVERA
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:PB25 CALLE 266
Mailing Address - Street 2:COUNTRY CLUB
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982
Mailing Address - Country:US
Mailing Address - Phone:787-632-1731
Mailing Address - Fax:
Practice Address - Street 1:OD1 CALLE 501
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982
Practice Address - Country:US
Practice Address - Phone:787-632-1731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16186-I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice