Basic Information
Provider Information
NPI: 1447362181
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NUNEZ
FirstName: MARTHA
MiddleName: HOPKINS
NamePrefix: MS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOPKINS
OtherFirstName: MARTHA
OtherMiddleName: ANN
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential: ARNP
OtherLastNameType: 1
Mailing Information
Address1: 1000 36TH ST
Address2:  
City: VERO BEACH
State: FL
PostalCode: 329604862
CountryCode: US
TelephoneNumber: 7725674311
FaxNumber: 7725634634
Practice Location
Address1: 1000 36TH ST
Address2:  
City: VERO BEACH
State: FL
PostalCode: 329604862
CountryCode: US
TelephoneNumber: 7725674311
FaxNumber: 7725634634
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 12/07/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XARNP2622142FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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