Healthcare Provider Details

I. General information

NPI: 1568554129
Provider Name (Legal Business Name): JOSEPH KEITH MEUNIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W MILLER ST
ORLANDO FL
32806-3910
US

IV. Provider business mailing address

105 W MILLER ST
ORLANDO FL
32806-3910
US

V. Phone/Fax

Practice location:
  • Phone: 407-648-3800
  • Fax: 407-425-5203
Mailing address:
  • Phone: 407-648-3800
  • Fax: 407-425-5203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberOS16232
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number5101014184
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number5101014184
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: