Provider Demographics
NPI:1043808975
Name:MUNOZ, MICHAEL (PMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:PMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 NW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1484
Mailing Address - Country:US
Mailing Address - Phone:866-828-4768
Mailing Address - Fax:
Practice Address - Street 1:9150 NW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33178-1484
Practice Address - Country:US
Practice Address - Phone:866-828-4768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMD506196207PE0004X, 146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services