Healthcare Provider Details

I. General information

NPI: 1164457834
Provider Name (Legal Business Name): WILLIAM MUINOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 12/08/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8955 SW 87TH CT STE 206
MIAMI FL
33176-2223
US

IV. Provider business mailing address

3200 SW 60TH CT STE 204
MIAMI FL
33155-4070
US

V. Phone/Fax

Practice location:
  • Phone: 786-888-2480
  • Fax:
Mailing address:
  • Phone: 305-661-6110
  • Fax: 305-662-5882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberME57049
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: