Healthcare Provider Details

I. General information

NPI: 1962715540
Provider Name (Legal Business Name): ANA T MUNOZ-MATTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2010
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PASEO JOSE CELSO BARBOSA BO. MONACILLOS
SAN PR
00935-0001
US

IV. Provider business mailing address

1863 AVE FERNANDEZ JUNCOS APT 606
SAN JUAN PR
00909-3035
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-0101
  • Fax:
Mailing address:
  • Phone: 787-672-2037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA09515300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number22050
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number280617-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: