Provider Demographics
NPI:1215547013
Name:ALMONTE NUNEZ, MARLI CAROLINA (MD)
Entity type:Individual
Prefix:
First Name:MARLI
Middle Name:CAROLINA
Last Name:ALMONTE NUNEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARLI
Other - Middle Name:CAROLINA
Other - Last Name:ALMONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:393-437-1002
Mailing Address - Fax:239-468-7924
Practice Address - Street 1:16271 BASS RD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3616
Practice Address - Country:US
Practice Address - Phone:239-343-7100
Practice Address - Fax:239-468-7924
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR36581R390200000X
FLME166773207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL123791100Medicaid