MEDICARE: JOSEPH C MUNAFO III 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	174400000X	Specialist
2	207P00000X	Emergency Medicine Physician	ME0077075	FL
3	2084P0800X	Psychiatry Physician	ME77075	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740253657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH C MUNAFO III MD

Provider Business Mailing Address
First Line	:	4740 N STATE ROAD 7
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5839
Country	:	US
Telephone Number	:	954-486-4005
Fax Number	:	954-497-3857

Provider Business Practice Location Address
First Line	:	4720 N STATE ROAD 7 BLDG B
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5860
Country	:	US
Telephone Number	:	954-730-7284
Fax Number	:	954-486-4005

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	11/17/2017

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