Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | PMD506196 | FL |
NPI | 1043808975 |
---|---|
Provider Name | Michael Munoz |
First Address | Medley, FL 33178-1484 |
Second Address | Medley, FL 33178-1484 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2021 |
Last Update Date | 06/01/2021 |