Provider Demographics
NPI:1982473229
Name:NUNEZ FERNANDEZ, JONATHAN MANUEL
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:MANUEL
Last Name:NUNEZ FERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3277 MILL RUN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5211
Mailing Address - Country:US
Mailing Address - Phone:787-344-0237
Mailing Address - Fax:
Practice Address - Street 1:5601 ARRINGDON PARK DR STE 150
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5677
Practice Address - Country:US
Practice Address - Phone:919-385-6510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP22796225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist