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General NPI Number Information
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NPI Number | 1699289025
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Entity Type | Individual
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Provider Name | RICARDO CAMPOS MUNOZ ARNP
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Gender | Male
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 4160 W 16TH AVE STE 506
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City | HIALEAH
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State | FL
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Zip | 33012-5884
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Country | US
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Telephone | 305-821-3099
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Fax |
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Provider Business Mailing Address
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Address Line | 18620 SW 98TH AVE
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City | CUTLER BAY
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State | FL
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Zip | 33157-6947
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Country | US
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Telephone | 305-821-3099
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9402094
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License Number State | FL
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