Healthcare Provider Details

I. General information

NPI: 1407690902
Provider Name (Legal Business Name): MARIA MUNOZ ESTRELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 JACK BRACK RD
SAINT CLOUD FL
34771-7859
US

IV. Provider business mailing address

5000 JACK BRACK RD
SAINT CLOUD FL
34771-7859
US

V. Phone/Fax

Practice location:
  • Phone: 407-887-1778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32265
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: