Healthcare Provider Details

I. General information

NPI: 1083823637
Provider Name (Legal Business Name): JAVIER LUIS MUNOZ M.D., M.S., F.A.C.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. JORGE LUIS JAVIER MUNOZ VEGA

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5881 E MAYO BLVD
PHOENIX AZ
85054-4504
US

IV. Provider business mailing address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5452
US

V. Phone/Fax

Practice location:
  • Phone: 480-342-4800
  • Fax: 480-301-4675
Mailing address:
  • Phone: 480-301-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine
License Number46881
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine
License Number4301085405
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine
License NumberP1369
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology
License Number46881
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: