Provider Demographics
NPI:1114019874
Name:MUNIZ, CAMILLE (PT)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 CALLE ALAMEDA
Mailing Address - Street 2:VILLA GRANADA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-2725
Mailing Address - Country:US
Mailing Address - Phone:787-525-6467
Mailing Address - Fax:
Practice Address - Street 1:906 ALAMEDA STREET
Practice Address - Street 2:VILLA GRANADA
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00923
Practice Address - Country:BG
Practice Address - Phone:787-525-6467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist