Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 17645 | PR |
Y | 2084N0402X | Child Neurologist | 17645 | PR |
N | 2084N0600X | Clinical Neurophysiologist | 17645 | PR |
NPI | 1285832741 |
---|---|
Provider Name | Dr. Jorge Fernando Munoz |
First Address | San Juan, PR 00912 |
Second Address | San Juan, PR 00912-3113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2007 |
Last Update Date | 20/03/2015 |