Healthcare Provider Details

I. General information

NPI: 1912214107
Provider Name (Legal Business Name): JOSUE RAUL MUNIZ HERNANDEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 02/09/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE JULIO CINTRON #204 EDIFICIO GUAYACAN OFICINA #112
AIBONITO PR
00705
US

IV. Provider business mailing address

PO BOX 1035
AIBONITO PR
00705-1035
US

V. Phone/Fax

Practice location:
  • Phone: 787-991-3222
  • Fax: 787-735-4152
Mailing address:
  • Phone: 787-235-4096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number18007
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: