Individual
DR. JACKELINE NUNEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5425 PARK ST N STE 7W, ST PETERSBURG, FL 33709-7042
(727) 202-8140
Mailing address
2370 CORPORATE CIR STE 300, HENDERSON, NV 89074-7760
(702) 910-3950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ACN487
FL
207R00000X
Internal Medicine Physician
ACN487
FL
207VG0400X
Gynecology Physician
ACN487
FL
208D00000X
General Practice Physician
Primary
ACN487
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010963800
—
FL
01
—
ACN487
FL MEDICAL LICENSE
FL
Enumeration date
02/23/2007
Last updated
05/03/2024
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