Healthcare Provider Details

I. General information

NPI: 1306206461
Provider Name (Legal Business Name): JACQUELINE MUNOZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2016
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 S OLD DIXIE HWY
JUPITER FL
33458-7205
US

IV. Provider business mailing address

1613 HARRISON PKWY BLDG C SUITE 200
SUNRISE FL
33323-2896
US

V. Phone/Fax

Practice location:
  • Phone: 561-263-2234
  • Fax:
Mailing address:
  • Phone: 954-514-4694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9235861
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: