Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 0732 | PR |
NPI | 1073612099 |
---|---|
Provider Name | Dr. Oscar Muniz SR. |
First Address | Mayaguez, PR 00680-4949 |
Second Address | Mayaguez, PR 00680-4949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OTH000 | (02) | PR |