1023338795 NPI number — MRS. MARTA PATRICIA MUNOZ SLP

Table of content: MRS. MARTA PATRICIA MUNOZ SLP (NPI 1023338795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023338795 NPI number — MRS. MARTA PATRICIA MUNOZ SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUNOZ
Provider First Name:
MARTA
Provider Middle Name:
PATRICIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023338795
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
B18 CALLE ZENOBIA
Provider Second Line Business Mailing Address:
VILLAS DE CUPEY
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-7622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-203-0442
Provider Business Mailing Address Fax Number:
787-783-1325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
B18 CALLE ZENOBIA
Provider Second Line Business Practice Location Address:
VILLAS DE CUPEY
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926-7622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-203-0442
Provider Business Practice Location Address Fax Number:
787-783-1325
Provider Enumeration Date:
06/04/2010

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: 235Z00000X , with the licence number:  865 , 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)