Healthcare Provider Details

I. General information

NPI: 1609160027
Provider Name (Legal Business Name): JEAN-PIERRE B. MUHUMUZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2011
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1371 CITRUS TOWER BLVD
CLERMONT FL
34711-1924
US

IV. Provider business mailing address

1371 CITRUS TOWER BLVD
CLERMONT FL
34711-1924
US

V. Phone/Fax

Practice location:
  • Phone: 352-708-4828
  • Fax: 352-708-4833
Mailing address:
  • Phone: 352-708-4828
  • Fax: 352-708-4833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME120215
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: