Provider Demographics
NPI:1447054754
Name:MUNOZ, ALYSSA LUISA (APRN)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LUISA
Last Name:MUNOZ
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15841 SW 49TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4939
Mailing Address - Country:US
Mailing Address - Phone:954-647-3288
Mailing Address - Fax:
Practice Address - Street 1:3061 SW 160TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4213
Practice Address - Country:US
Practice Address - Phone:754-800-9465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily