Provider Demographics
NPI:1447954060
Name:NUNEZ MARTINEZ, LISBETY
Entity type:Individual
Prefix:
First Name:LISBETY
Middle Name:
Last Name:NUNEZ MARTINEZ
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 1:3540 W 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5206
Mailing Address - Country:US
Mailing Address - Phone:786-369-6517
Mailing Address - Fax:786-522-7204
Practice Address - Street 1:3540 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5206
Practice Address - Country:US
Practice Address - Phone:786-369-6517
Practice Address - Fax:786-522-7204
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician