Healthcare Provider Details

I. General information

NPI: 1972067643
Provider Name (Legal Business Name): CLARILIZ MUNET-COLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE STE 1135
ATLANTA GA
30308-2234
US

IV. Provider business mailing address

48 AVE MUNOZ RIVERA APT 2505
SAN JUAN PR
00918-1652
US

V. Phone/Fax

Practice location:
  • Phone: 787-453-2887
  • Fax:
Mailing address:
  • Phone: 787-453-2887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number15976
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number111072
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: