Healthcare Provider Details

I. General information

NPI: 1215936505
Provider Name (Legal Business Name): JOSE RADAMES MUNIZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOSE R MUNIZ MELENDEZ M.D.

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 AVE MIGUEL MELENDEZ MUNOZ
CAYEY PR
00736-4609
US

IV. Provider business mailing address

PO BOX 372139
CAYEY PR
00737-2139
US

V. Phone/Fax

Practice location:
  • Phone: 787-263-3138
  • Fax: 787-263-2205
Mailing address:
  • Phone: 787-263-3138
  • Fax: 787-263-2205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number7535
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: