1720596661 NPI number — MR. EMID NUNEZ CERTIFIED COACH

Table of content: MR. EMID NUNEZ CERTIFIED COACH (NPI 1720596661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720596661 NPI number — MR. EMID NUNEZ CERTIFIED COACH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NUNEZ
Provider First Name:
EMID
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CERTIFIED COACH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NUNEZ
Provider Other First Name:
EMID
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CERTIFIED COACH
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1720596661
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
A14 AVE ESTEBES
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UTUADO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-933-7887
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
A14 AVE ESTEBES
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UTUADO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-933-7887
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174H00000X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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