Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | APRN11002973 | FL |
NPI | 1013579002 |
---|---|
Provider Name | Alicia Nunez |
First Address | Oviedo, FL 32765-9262 |
Second Address | Oviedo, FL 32765-9262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2019 |
Last Update Date | 01/07/2019 |