MEDICARE: YAMIRA ROSARIO MUNOZ

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	103TC1900X	Counseling Psychologist	7451	PR

General Provider Information

NPI Number	:	1376351692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMIRA ROSARIO MUNOZ

Provider Business Mailing Address
First Line	:	PO BOX 20533
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00928-0533
Country	:	US
Telephone Number	:	939-418-8023
Fax Number	:

Provider Business Practice Location Address
First Line	:	2436 CALLE SANTA ELENA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00915-3133
Country	:	US
Telephone Number	:	939-418-8023
Fax Number	:

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

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	12/19/2024

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Directions to “ YAMIRA ROSARIO MUNOZ ” Practice Location

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