| Doctor Name: | DOMINEQUE D NUNEZ |
| NPI Number: | 1073753133 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 07001473 |
| Business Practice Address: | Exti 102 Off I - 40 1/2 Mi South San Fidel, NM - 870490130 |
| Business Phone Number: | 5055525385 |
| Business Fax Number: | 5055529473 |
| Mailing Address: | Po Box 130, SAN FIDEL |
| State: | NM |
| Postal Code: | 870490130 |
| Phone Number: | 5055525385 |
| Fax Number: | 5055529473 |
| NPI Enumeration Date: | 03/03/2009 |
| NPI Last Update Date: | 03/03/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146N00000X |
| License Number: | 07001473 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Basic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |