Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 8219 | KY |
N | 1223G0001X | General Practice | 8219 | KY |
N | 213EG0000X | General Practice | 8219 | KY |
NPI | 1063518553 |
---|---|
Provider Name | Cindy Munoz |
First Address | Lexington, KY 40511-2276 |
Second Address | Lexington, KY 40511-2275 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 20/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8219 | LICENSE (01) | KY |