Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 7535 | PR |
NPI | 1215936505 |
---|---|
Provider Name | Dr. Jose Radames Muniz |
First Address | Cayey, PR 00737-2139 |
Second Address | Cayey, PR 00736-4609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 25/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E16917 | (02) | PR |