Provider Demographics
NPI:1659004141
Name:MUNOZ, ANGIE (DMD)
Entity type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13499 BISCAYNE BLVD APT 502
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2026
Mailing Address - Country:US
Mailing Address - Phone:786-440-9672
Mailing Address - Fax:
Practice Address - Street 1:790 E BROWARD BLVD
Practice Address - Street 2:SUITE 121
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-3240
Practice Address - Country:US
Practice Address - Phone:786-440-9672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-03
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN272001223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice