Provider Demographics
NPI:1871102368
Name:NUNEZ, AMANDA NICOLE (DC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:NICOLE
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO LAGOPLAYA CALLE CORAL
Mailing Address - Street 2:APT 3022
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:404-974-7839
Mailing Address - Fax:
Practice Address - Street 1:CONDOMINIO LAGOPLAYA CALLE CORAL 3000
Practice Address - Street 2:APT 3022
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:404-974-7839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR721111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor