Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 01051002A | IN |
Y | 207T00000X | Neurosurgeon | ME110815 | FL |
NPI | 1093712572 |
---|---|
Provider Name | Dr. Michael Munz |
First Address | Gainesville, FL 32610-0001 |
Second Address | Gainesville, FL 32610-4898 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 14/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004315900 | (05) | FL |
140006313 | RR MEDICARE (01) | IN |
200211180 | (05) | IN |
2142274 | (05) | OH |
2717856 | (05) | MI |
F28359 | (02) |