MEDICARE: MARIETTA 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	225700000X	Massage Therapist	MA67384	FL

General Provider Information

NPI Number	:	1477128775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIETTA MUNOZ

Provider Business Mailing Address
First Line	:	25795 SW 122ND CT
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33032-7065
Country	:	US
Telephone Number	:	305-910-9305
Fax Number	:

Provider Business Practice Location Address
First Line	:	25795 SW 122ND CT
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33032-7065
Country	:	US
Telephone Number	:	305-910-9305
Fax Number	:

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

Provider Enumeration Date	:	05/20/2021
Last Update Date	:	05/20/2021

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Directions to “ MARIETTA MUNOZ ” Practice Location

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