1336206689 NPI number — JOAQUIN A. NUNEZ,MD,PA

Table of content: (NPI 1336206689)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336206689 NPI number — JOAQUIN A. NUNEZ,MD,PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOAQUIN A. NUNEZ,MD,PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JOAQUIN A. NUNEZ,MD
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336206689
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2925 10TH AVE N
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
LAKE WORTH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-969-9252
Provider Business Mailing Address Fax Number:
561-969-9257

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2925 10TH AVE N
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
LAKE WORTH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33461-3000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-969-9252
Provider Business Practice Location Address Fax Number:
561-969-9257
Provider Enumeration Date:
01/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NUNEZ
Authorized Official First Name:
JOAQUIN
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-969-9252

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 298440 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 000004205376 . This is a "HEALTHY PALM BEACHES" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 16758 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 16758 . This is a "HEALTHEASE FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 16758 . This is a "STAYWELL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 26724 . This is a "BLUECROSS AND BLUESHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 240623 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 26725 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 207372 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 8103245 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: SG07476F500 . This is a "VISTA HEALTHPLANS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 000004205377 . This is a "HEALTHY PALM BEACHES" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: A59907-F500 . This is a "VISTA HEALTHPLANS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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