MEDICARE: SASHA MUNIZ NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11031701	FL

General Provider Information

NPI Number	:	1235959859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SASHA MUNIZ NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	2829 VAN BUREN ST APT 107
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4236
Country	:	US
Telephone Number	:	305-746-9851
Fax Number	:

Provider Business Practice Location Address
First Line	:	2829 VAN BUREN ST APT 107
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4236
Country	:	US
Telephone Number	:	305-746-9851
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2024
Last Update Date	:	10/17/2024

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