Provider Demographics
NPI:1780885855
Name:NUNEZ, MARGARITA (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARITA
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 W DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-4040
Mailing Address - Country:US
Mailing Address - Phone:813-251-4496
Mailing Address - Fax:
Practice Address - Street 1:11201 CORPORATE CIRCLE NORTH
Practice Address - Street 2:SUITE 200
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716
Practice Address - Country:US
Practice Address - Phone:727-641-0397
Practice Address - Fax:727-576-7632
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053466174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE30584Medicare UPIN