Healthcare Provider Details

I. General information

NPI: 1679749436
Provider Name (Legal Business Name): GIANNINA L GARCES-AMBROSSI MUNCEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GIANNINA L MUNCEY MD

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 01/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 N FLAGLER DR
WEST PALM BEACH FL
33401-3406
US

IV. Provider business mailing address

1825 NW CORPORATE BLVD SUITE 105
BOCA RATON FL
33431-8559
US

V. Phone/Fax

Practice location:
  • Phone: 561-655-5511
  • Fax:
Mailing address:
  • Phone: 561-299-3667
  • Fax: 561-299-3670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberME124931
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: