Healthcare Provider Details

I. General information

NPI: 1003115551
Provider Name (Legal Business Name): WILLIAM MUNOZ III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 01/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 GLADES RD STE 460
BOCA RATON FL
33431-6469
US

IV. Provider business mailing address

660 GLADES RD STE 460
BOCA RATON FL
33431-6469
US

V. Phone/Fax

Practice location:
  • Phone: 561-391-5515
  • Fax: 561-347-7470
Mailing address:
  • Phone: 561-391-5515
  • Fax: 561-347-7470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberME131881
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: