MEDICARE: VANESSA I MUNIZ PA-C

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	363AM0700X	Medical Physician Assistant	PA9105147	FL

General Provider Information

NPI Number	:	1619202629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA I MUNIZ PA-C

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 600
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5250
Country	:	US
Telephone Number	:	888-987-1151
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 49TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-6612
Country	:	US
Telephone Number	:	727-870-3032
Fax Number	:	727-870-6557

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

Provider Enumeration Date	:	10/08/2009
Last Update Date	:	02/02/2026

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