Provider Demographics
NPI:1124845458
Name:NUNEZ, VIVIAN TAMARA (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:TAMARA
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 SW 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-5062
Mailing Address - Country:US
Mailing Address - Phone:305-316-9120
Mailing Address - Fax:
Practice Address - Street 1:17670 NW 78TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3664
Practice Address - Country:US
Practice Address - Phone:305-440-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT25623225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist