Healthcare Provider Details
I. General information
NPI: 1841227634
Provider Name (Legal Business Name): RAFAEL ANTONIO MUNNE QUINTANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/27/2006
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2318 NW BAY COLONY CT
STUART FL
34994-9129
US
IV. Provider business mailing address
2318 NW BAY COLONY CT
STUART FL
34994-9129
US
V. Phone/Fax
- Phone: 772-323-4418
- Fax:
- Phone: 772-323-4418
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | ME0071804 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: