Provider Demographics
NPI:1154967529
Name:NUNEZ, SAMANTHA (DME PROVIDER)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:DME PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 HOLLYWOOD BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4858
Mailing Address - Country:US
Mailing Address - Phone:718-810-6509
Mailing Address - Fax:
Practice Address - Street 1:2640 HOLLYWOOD BLVD STE 209
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4858
Practice Address - Country:US
Practice Address - Phone:718-810-6509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies