1215936505 NPI number — DR. JOSE RADAMES MUNIZ M.D.

Table of content: DR. JOSE RADAMES MUNIZ M.D. (NPI 1215936505)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215936505 NPI number — DR. JOSE RADAMES MUNIZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUNIZ
Provider First Name:
JOSE
Provider Middle Name:
RADAMES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MUNIZ MELENDEZ
Provider Other First Name:
JOSE
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1215936505
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 372139
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAYEY
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00737-2139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-263-3138
Provider Business Mailing Address Fax Number:
787-263-2205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 AVE MIGUEL MELENDEZ MUNOZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAYEY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00736-4609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-263-3138
Provider Business Practice Location Address Fax Number:
787-263-2205
Provider Enumeration Date:
07/19/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207QG0300X , with the licence number:  7535 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)