Individual
HEATHER NUNNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 S ANDREWS AVE STE 101, FORT LAUDERDALE, FL 33316-2510
(954) 355-4345
(954) 355-4889
Mailing address
1608 SE 3RD AVE FL 3, FORT LAUDERDALE, FL 33316-2564
(954) 355-4345
(954) 355-4889
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9109811
FL
Other
Enumeration date
03/22/2017
Last updated
10/20/2025
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