Provider Demographics
NPI:1144106840
Name:NUNEZ, CARMEN ROSA
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:ROSA
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6265 SW 129TH PL APT 2301
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5249
Mailing Address - Country:US
Mailing Address - Phone:305-399-6195
Mailing Address - Fax:
Practice Address - Street 1:6265 SW 129TH PL APT 2301
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-5249
Practice Address - Country:US
Practice Address - Phone:305-399-6195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1303847106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty