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General NPI Number Information
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NPI Number | 1003161670
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Entity Type | Individual
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Provider Name | JONATHAN MUNIZ M.S.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2012
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 60 CALLE DAGUEY
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City | ANASCO
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State | PR
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Zip | 00610-2603
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Country | US
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Telephone | 787-229-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 7 CERRO MIRAMAR
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City | RINCON
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State | PR
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Zip | 00677-2606
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Country | US
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Telephone | 787-546-2066
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4301
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License Number State | PR
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