Healthcare Provider Details

I. General information

NPI: 1639115959
Provider Name (Legal Business Name): ANNMARIE GONZALEZ MUNOZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST APC 6TH FLR
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

593 EDDY ST APC 6TH FLR
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 401-793-9166
  • Fax: 401-444-2788
Mailing address:
  • Phone: 401-793-9166
  • Fax: 401-444-2788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301518628
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD12851
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number12851
License Number StateRI
# 4
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number4301518628
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number042-0010288
License Number StateVT
# 6
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMD12851
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: