Provider Demographics
NPI:1174526040
Name:NUNAG, JOEL MENDOZA (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:MENDOZA
Last Name:NUNAG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10222 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-8375
Mailing Address - Country:US
Mailing Address - Phone:352-597-9797
Mailing Address - Fax:352-597-5556
Practice Address - Street 1:10222 YALE AVE
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34613-8375
Practice Address - Country:US
Practice Address - Phone:352-597-9797
Practice Address - Fax:352-597-5556
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME82024207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H42234Medicare UPIN