Provider Demographics
NPI:1083701791
Name:LLOBERA-BUNCE, RAQUEL (PHD)
Entity type:Individual
Prefix:DR
First Name:RAQUEL
Middle Name:
Last Name:LLOBERA-BUNCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 560095
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-0095
Mailing Address - Country:US
Mailing Address - Phone:305-790-3932
Mailing Address - Fax:
Practice Address - Street 1:8333 W OKECHOBE RD
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2109
Practice Address - Country:US
Practice Address - Phone:305-556-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 5635103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54168AMedicare PIN