Healthcare Provider Details

I. General information

NPI: 1447645015
Provider Name (Legal Business Name): DR. AMANDA MUNOZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 05/31/2025
Certification Date: 05/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

848 ADAMS AVE
MEMPHIS TN
38103-2816
US

IV. Provider business mailing address

50 N DUNLAP ST FL 6
MEMPHIS TN
38103-2800
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-5437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA149901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: