MEDICARE: DR. JESUS MUNIZ

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	174400000X	Specialist	8599	PR

General Provider Information

NPI Number	:	1457350100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESUS MUNIZ

Provider Business Mailing Address
First Line	:	PO BOX 3406
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00970-3406
Country	:	US
Telephone Number	:	787-778-1711
Fax Number	:	787-790-5246

Provider Business Practice Location Address
First Line	:	73 CALLE SANTA CRUZ
Second Line	:	SUITE 410
City	:	BAYAMON
State	:	PR
Zip	:	00961-6910
Country	:	US
Telephone Number	:	787-778-1711
Fax Number	:	787-790-5246

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. JESUS MUNIZ ” Practice Location

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