Healthcare Provider Details

I. General information

NPI: 1659067387
Provider Name (Legal Business Name): GLORIA PAULETTE LABOY MUNIZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GLORIA PAULETTE MUNIZ DE LEON MD

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 HORSHAM RD STE 10
LOWER GWYNEDD PA
19002-1143
US

IV. Provider business mailing address

PO BOX 788735
PHILADELPHIA PA
19178-8735
US

V. Phone/Fax

Practice location:
  • Phone: 215-643-8500
  • Fax: 215-643-6999
Mailing address:
  • Phone: 215-456-7000
  • Fax: 215-254-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD489655
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: