Provider Demographics
NPI:1114290491
Name:MUNIZ, NEYSHA M (SPL)
Entity Type:Individual
Prefix:MRS
First Name:NEYSHA
Middle Name:M
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:SPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8345
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-8345
Mailing Address - Country:US
Mailing Address - Phone:787-635-5343
Mailing Address - Fax:787-797-7622
Practice Address - Street 1:11-6 CALLE 55
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4508
Practice Address - Country:US
Practice Address - Phone:787-635-5343
Practice Address - Fax:787-797-7622
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1057235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist