Provider Demographics
NPI:1215970405
Name:BERMUDEZ NUNEZ, DAVID R (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:BERMUDEZ NUNEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:R
Other - Last Name:BERMUDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DAVID R BERMUDEZ, MD
Mailing Address - Street 1:PO BOX 3736
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3736
Mailing Address - Country:US
Mailing Address - Phone:787-892-4965
Mailing Address - Fax:787-264-2340
Practice Address - Street 1:100 CALLE HERNAN ALVAREZ
Practice Address - Street 2:EDIFICIO PLAZA METROPOLITANA, OFICINA 104
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4173
Practice Address - Country:US
Practice Address - Phone:787-892-4965
Practice Address - Fax:787-264-2340
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13096207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH65021Medicare UPIN
PR20873Medicare ID - Type Unspecified