Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | ME80368 | FL |
NPI | 1083680839 |
---|---|
Provider Name | Robert A Nunez |
First Address | Stuart, FL 34996-3341 |
Second Address | Stuart, FL 34996-3341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 22/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010064616 | RAILROAD MEDICARE PIN (01) | FL |
H19399 | (02) | FL |