MEDICARE: DR. ERNESTO A MUNOZ GUADALUPE MD

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	207R00000X	Internal Medicine Physician	22512	PR

General Provider Information

NPI Number	:	1376104836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNESTO A MUNOZ GUADALUPE MD

Provider Business Mailing Address
First Line	:	29 CALLE WASHINGTON STE 208B
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1561
Country	:	US
Telephone Number	:	787-721-4836
Fax Number	:	787-721-8448

Provider Business Practice Location Address
First Line	:	29 CALLE WASHINGTON STE 208B
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1561
Country	:	US
Telephone Number	:	787-721-4836
Fax Number	:	787-721-8448

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

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	01/14/2026

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