Basic Information
| Provider Information | |||||||||
| NPI: | 1033610068 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NUNES | ||||||||
| FirstName: | FERNANDA | ||||||||
| MiddleName: | ULIANO | ||||||||
| NamePrefix: | |||||||||
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| Credential: | BA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 17TH ST | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347696098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3212411170 | ||||||||
| FaxNumber: | 3212411171 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 17TH ST | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347696098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3212411170 | ||||||||
| FaxNumber: | 3212411171 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2018 | ||||||||
| LastUpdateDate: | 01/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | FL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.