Provider Demographics
NPI:1962795005
Name:NERY, DUNN MICHAEL PAPA (PT)
Entity type:Individual
Prefix:MR
First Name:DUNN MICHAEL
Middle Name:PAPA
Last Name:NERY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 W COMMERCIAL BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3444
Mailing Address - Country:US
Mailing Address - Phone:239-850-2248
Mailing Address - Fax:866-422-6431
Practice Address - Street 1:711 SUSAN TART RD
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-5557
Practice Address - Country:US
Practice Address - Phone:910-892-3298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13116225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist