MEDICARE: DR. MARCO MUNIZ D.O., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	OS 7754	FL
2	207Q00000X	Family Medicine Physician	OS7754	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790800118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCO MUNIZ D.O., M.P.H.

Provider Business Mailing Address
First Line	:	841 PRUDENTIAL DR STE 1400
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8364
Country	:	US
Telephone Number	:	904-396-5682
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 HEALTH PARK BLVD
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-5784
Country	:	US
Telephone Number	:	904-819-5155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	12/16/2024

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Directions to “ DR. MARCO MUNIZ D.O., M.P.H.” Practice Location

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