Provider Demographics
NPI:1093536880
Name:NUNEZ, LEONARDO (DC)
Entity type:Individual
Prefix:
First Name:LEONARDO
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6412 PINE FORK ALLY
Mailing Address - Street 2:
Mailing Address - City:ST CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771
Mailing Address - Country:US
Mailing Address - Phone:321-442-1942
Mailing Address - Fax:
Practice Address - Street 1:4028 13TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771
Practice Address - Country:US
Practice Address - Phone:407-957-9995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty