Provider Demographics
NPI:1447024807
Name:FERNANDEZ NUNEZ, OLGA (CBHCMS)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:FERNANDEZ NUNEZ
Suffix:
Gender:F
Credentials:CBHCMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3346 SE 2ND CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7476
Mailing Address - Country:US
Mailing Address - Phone:469-528-5217
Mailing Address - Fax:
Practice Address - Street 1:3346 SE 2ND CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7476
Practice Address - Country:US
Practice Address - Phone:469-528-5217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCMS.0102660101YM0800X, 171M00000X
FLRBT-23-309442106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician