Individual
JACK MARTINS NUNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
9117 SW 87TH AVE, MIAMI, FL 33176-2302
(305) 279-2335
(305) 279-7989
Mailing address
PO BOX 166482, MIAMI, FL 33116-6482
(305) 275-5677
(305) 279-7989
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT26672
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT 26672
MEDICAL LICENSE
FL
Enumeration date
10/21/2011
Last updated
10/21/2011
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