Basic Information
| Provider Information | |||||||||
| NPI: | 1477586204 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NUNEZ | ||||||||
| FirstName: | EDGARD | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 810 W MOWRY DR | ||||||||
| Address2: | |||||||||
| City: | HOMESTEAD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330305746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052426015 | ||||||||
| FaxNumber: | 3052451161 | ||||||||
| Practice Location | |||||||||
| Address1: | 810 W MOWRY DR | ||||||||
| Address2: | |||||||||
| City: | HOMESTEAD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330305746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052426015 | ||||||||
| FaxNumber: | 3052451161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 06/25/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | ME84491 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207Q00000X | ME84491 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.